Peripheral Artery Disease: Past, Present, and Future

Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our i...

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Vydáno v:The American journal of medicine Ročník 132; číslo 10; s. 1133
Hlavní autoři: Campia, Umberto, Gerhard-Herman, Marie, Piazza, Gregory, Goldhaber, Samuel Z
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.10.2019
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ISSN:1555-7162, 1555-7162
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Abstract Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease, bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity, increase awareness of critical limb ischemia, briefly describe the diagnostic role of the ankle brachial index, and go over the contemporary management of peripheral artery disease. An emphasis is placed on evidence-based medical treatments to improve symptoms and quality of life and to reduce the risk of cardiovascular and limb events in these patients, including supervised exercise training, smoking cessation, antagonism of the renin-angiotensin system, lipid-lowering, antiplatelet, and antithrombotic therapies.
AbstractList Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease, bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity, increase awareness of critical limb ischemia, briefly describe the diagnostic role of the ankle brachial index, and go over the contemporary management of peripheral artery disease. An emphasis is placed on evidence-based medical treatments to improve symptoms and quality of life and to reduce the risk of cardiovascular and limb events in these patients, including supervised exercise training, smoking cessation, antagonism of the renin-angiotensin system, lipid-lowering, antiplatelet, and antithrombotic therapies.Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease, bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity, increase awareness of critical limb ischemia, briefly describe the diagnostic role of the ankle brachial index, and go over the contemporary management of peripheral artery disease. An emphasis is placed on evidence-based medical treatments to improve symptoms and quality of life and to reduce the risk of cardiovascular and limb events in these patients, including supervised exercise training, smoking cessation, antagonism of the renin-angiotensin system, lipid-lowering, antiplatelet, and antithrombotic therapies.
Peripheral artery disease is a prevalent but underdiagnosed manifestation of atherosclerosis. There is insufficient awareness of its clinical manifestations, including intermittent claudication and critical limb ischemia and of its risk of adverse cardiovascular and limb outcomes. In addition, our inadequate knowledge of its pathophysiology has also limited the development of effective treatments, particularly in the presence of critical limb ischemia. This review aims to highlight essential elements of the epidemiology and pathophysiology of peripheral artery disease, bring attention to the often-atypical manifestations of occlusive arterial disease of the lower extremity, increase awareness of critical limb ischemia, briefly describe the diagnostic role of the ankle brachial index, and go over the contemporary management of peripheral artery disease. An emphasis is placed on evidence-based medical treatments to improve symptoms and quality of life and to reduce the risk of cardiovascular and limb events in these patients, including supervised exercise training, smoking cessation, antagonism of the renin-angiotensin system, lipid-lowering, antiplatelet, and antithrombotic therapies.
Author Gerhard-Herman, Marie
Goldhaber, Samuel Z
Campia, Umberto
Piazza, Gregory
Author_xml – sequence: 1
  givenname: Umberto
  surname: Campia
  fullname: Campia, Umberto
  email: ucampia@bwh.harvard.edu
  organization: Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston. Electronic address: ucampia@bwh.harvard.edu
– sequence: 2
  givenname: Marie
  surname: Gerhard-Herman
  fullname: Gerhard-Herman, Marie
  organization: Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston
– sequence: 3
  givenname: Gregory
  surname: Piazza
  fullname: Piazza, Gregory
  organization: Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston
– sequence: 4
  givenname: Samuel Z
  surname: Goldhaber
  fullname: Goldhaber, Samuel Z
  organization: Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston
BackLink https://www.ncbi.nlm.nih.gov/pubmed/31150643$$D View this record in MEDLINE/PubMed
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Keywords Peripheral artery disease
Critical limb ischemia
Cardiovascular risk
Intermittent claudication
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SubjectTerms Exercise
Humans
Peripheral Arterial Disease - diagnosis
Peripheral Arterial Disease - epidemiology
Peripheral Arterial Disease - pathology
Peripheral Arterial Disease - physiopathology
Quality of Life
Risk Factors
Title Peripheral Artery Disease: Past, Present, and Future
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