Peripheral artery disease in the lower limbs: The importance of secondary risk prevention for improved long-term prognosis

Aust J Gen Pract. 2020 May;49(5):239-244. doi: 10.31128/AJGP-11-19-5160.

Abstract

Background: Patients with lower limb peripheral artery disease (PAD) are at high risk of cardiovascular mortality and morbidity along with limb loss. PAD is underdiagnosed in the community and presents a missed opportunity to prescribe evidence-based secondary prevention therapy.

Objective: The aim of this article is to summarise key updates in the management of patients with PAD, with particular reference to newly published guidelines.

Discussion: PAD continues to be a major contributor to the mortality and morbidity of patients with atherosclerosis in Australia. For patients with chronic limb-threatening ischaemia, revascularisation remains the mainstay of limb salvage, and expedited access to vascular surgery assessment is necessary. Both prescription of, and adherence to, evidence-based secondary prevention therapy is low. A greater emphasis on cardiovascular risk factor modification for all patients with PAD is required to improve long-term outcomes. General practitioners and vascular surgeons can work collaboratively to provide patient-centred, effective care to patients with PAD.

MeSH terms

  • Australia
  • Humans
  • Lower Extremity / blood supply*
  • Lower Extremity / physiopathology
  • Peripheral Arterial Disease / complications*
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / therapy
  • Prognosis*
  • Risk Factors
  • Secondary Prevention / methods
  • Secondary Prevention / standards