Risk factor stratification of peripheral arterial disease in the United Kingdom

Abstract

Objective: To document the patient characteristics, primary care and hospital management and QoL in patients with intermittent claudication in the United Kingdom. Also to determine the appropriate use of prophylactic therapy, to determine markers of high and low risk and to suggest approaches to optimise the management of peripheral arterial disease. Methods: 474 patients were recruited from 23 centres across the United Kingdom. Data was collected at baseline and at six months and risk factors profile was analysed. Results: Symptomatic disease is more prevalent in men and those above 60. A high proportion of patients were hypertensive and control of blood pressure was not optimal. Use of antiplatelet agents and lipid lowering therapy was less than satisfactory though it improved following hospital referral. Life style modification advice was patchy and not uniform and intensive support for such programmes was lacking. Majority of patients improved not only on clinical parameters but also their QoL over a six month period. 35% underwent peripheral imaging and 7.8% had an interventional procedure. 14% had a vascular event over six months. Low ABPI, high systolic pressure and prior CHD were significantly associated with development of all vascular events. Conclusions: Use of appropriate therapy to reduce the risk factor profile is less than optimal. There is a need for uniform national guidelines for appropriate management of peripheral arterial disease patients in the United Kingdom.