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Prevalence and outcomes of undiagnosed peripheral arterial disease among high risk patients in Australia: an Australian REACH sub-study


Si, S and Golledge, J and Norman, P and Nelson, M and Chew, D and Ademi, Z and Bhatt, DL and Steg, GP and Reid, CM, Prevalence and outcomes of undiagnosed peripheral arterial disease among high risk patients in Australia: an Australian REACH sub-study, Heart Lung and Circulation pp. 1-7. ISSN 1443-9506 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

DOI: doi:10.1016/j.hlc.2018.04.292


Background: Compared with other manifestations of cardiovascular disease, peripheral arterial disease (PAD) is under-diagnosed. This study aims to investigate the prevalence, risk profile and cardiovascular outcomes of undiagnosed PAD in Australian general practices.

Method: A sub-study of the Australian Reduction of Atherothrombosis for Continued Health (REACH) Registry, a prospective cohort study of patients at high risk of atherothrombosis recruited from Australian general practices. Eligible patients for this study had no previous clinical diagnosis of PAD and had an ankle-brachial index (ABI) ≤1.4 at recruitment.

Results: Peripheral arterial disease was undiagnosed in 34% Australian REACH participants, 28% patients had low ABI (ABI<0.9) and 11% had intermittent claudication (IC) based on responses to the Edinburgh Claudication Questionnaire (ECQ). We found no significant differences in risk factor control between patient with or without PAD. Intermittent claudication patients had higher risks of non-fatal cardiovascular events and PAD interventions at one year, whereas all-cause mortality rate was higher among patients with ABI<0.9, especially in those who also reported IC. Finally, an ABI<0.9, together with poorly controlled risk factors were independent predictors of incident IC at one year.

Conclusions: This study suggests a high rate of undiagnosed PAD among high risk patients in Australian primary health care. These patients are at high risk of events and therefore would potentially benefit from better secondary prevention measures.

Item Details

Item Type:Refereed Article
Keywords:ankle-brachial index, Australian primary health care, intermittent claudication, peripheral arterial disease
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nelson, M (Professor Mark Nelson)
ID Code:128419
Year Published:2018
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-09-20
Last Modified:2019-03-04

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