Patients with lower extremity peripheral artery disease should participate in structured exercise programs as well as take their prescribed medications, according to new guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC).
The guidelines were published online Nov. 13 in Circulation and the Journal of the American College of Cardiology.
“Periodically reassessing how we manage and treat complex diseases by incorporating the latest evidence is critical to ensure that clinicians are equipped to provide optimal care for their patients,” said Marie Gerhard-Herman, MD, chair of the writing group and a cardiologist at Brigham and Women’s Hospital in Boston, in a news release.
Approximately 8.5 million adults in the U.S. who are above 40 years old have lower extremity peripheral artery disease, which the writing committee noted was associated with significant morbidity, mortality and quality of life impairment. These guidelines pertain to disease of the aortoiliac, femoropopliteal and infrapopliteal arterial segments, but do not address nonatherosclerotic causes of lower extremity arterial disease.
The writing committee conducted an evidence review from January 2015 through September 2015 and identified relevant studies. The members also considered other trials published through September 2016 even though that was when they were writing the guidelines.
The committee mentioned that clinicians should evaluate patients for peripheral artery disease by assessing their clinical history and giving them a physical examination. If patients have peripheral artery disease, they should not smoke and should avoid second-hand smoke and follow guideline-directed management and therapy, including structured exercise and lifestyle modification. Examples of pharmacotherapy include antiplatelet medications to reduce the risk of blood clots and statins to lower cholesterol.
The writing committee also noted that it supported the use of the ankle-brachial index to initially diagnose peripheral artery disease.
In addition, the writing committee identified gaps in research and called for more randomized controlled trials as well as comparative effectiveness research studies and trials that focus on patient-centered outcomes such as functional parameters and quality of life.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.