Peripheral arterial disease primary prevention
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Differentiating Peripheral arterial disease from other Diseases |
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AHA/ACC Guidelines on Management of Lower Extremity PAD |
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Guidelines for Revascularization of Claudication in Lower Extremity PAD |
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Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD |
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Guidelines for Longitudinal Follow-up for Lower Extremity PAD |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2]; Rim Halaby
Overview
As atherosclerosis is the major cause of peripheral artery disease, its risk factors are the same as those of other atherosclerotic diseases. Diabetes mellitus, hypertension, dyslipidemia and smoking are considered as some of the most important modifiable risk factors. Hence, the primary prevention of PAD can be mainly achieved by smoking cessation as well as by the appropriate control of diabetes, blood pressure and lipid profile.
Primary Prevention
Treatment of Co-existing Medical Conditions
- Diabetes
- Dyslipidemia
- Hypertension
Life Style Modifications
- Exercise
- Healthy diet
- Smoking cessation
- Weight loss in case of obesity
Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations) : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[1]
Smoking Cessation (DO NOT EDIT)[2][3]
| Class I |
| "1. Patients who are smokers or former smokers should be asked about status of tobacco use at every visit.[4][5][6][7] (Level of Evidence: A)" |
| "2. Patients should be assisted with counseling and developing a plan for quitting that may include pharmacotherapy and/or referral to a smoking cessation program. [5][6][7][8](Level of Evidence: A)" |
| "3. Individuals with lower extremity PAD who smoke cigarettes or use other forms of tobacco should be advised by each of their clinicians to stop smoking and offered behavioral and pharmacological treatment. (Level of Evidence: C)" |
| "4. In the absence of contraindication or other compelling clinical indication, 1 or more of the following pharmacological therapies should be offered: varenicline, bupropion, and nicotine replacement therapy.[9][10][11][12] (Level of Evidence: A)" |
References
- ↑ Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss L; et al. (2013). "Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 61 (14): 1555–70. doi:10.1016/j.jacc.2013.01.004. PMC 4492473. PMID 23473760.
- ↑ Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B (2006). "ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation". Circulation. 113 (11): e463–654. doi:10.1161/CIRCULATIONAHA.106.174526. PMID 16549646. Retrieved 2012-10-09. Unknown parameter
|month=ignored (help) - ↑ "2011 ACCF/AHA Focused Update of the Guideline for the Management of patients with peripheral artery disease (Updating the 2005 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines". Circulation. 124 (18): 2020–45. 2011. doi:10.1161/CIR.0b013e31822e80c3. PMID 21959305. Retrieved 2012-10-10. Unknown parameter
|month=ignored (help) - ↑ Nides MA, Rakos RF, Gonzales D, Murray RP, Tashkin DP, Bjornson-Benson WM, Lindgren P, Connett JE (1995). "Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study". Journal of Consulting and Clinical Psychology. 63 (1): 60–9. PMID 7896992. Retrieved 2012-11-05. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 Mohiuddin SM, Mooss AN, Hunter CB, Grollmes TL, Cloutier DA, Hilleman DE (2007). "Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease". Chest. 131 (2): 446–52. doi:10.1378/chest.06-1587. PMID 17296646. Retrieved 2012-11-05. Unknown parameter
|month=ignored (help) - ↑ 6.0 6.1 Lancaster T, Stead LF (2000). "Mecamylamine (a nicotine antagonist) for smoking cessation". Cochrane Database of Systematic Reviews (Online) (2): CD001009. doi:10.1002/14651858.CD001009. PMID 10796584. Retrieved 2012-11-05.
- ↑ 7.0 7.1 Rothemich SF, Woolf SH, Johnson RE, Burgett AE, Flores SK, Marsland DW, Ahluwalia JS (2008). "Effect on cessation counseling of documenting smoking status as a routine vital sign: an ACORN study". Annals of Family Medicine. 6 (1): 60–8. doi:10.1370/afm.750. PMC 2203392. PMID 18195316. Retrieved 2012-11-05.
- ↑ Hennrikus D, Joseph AM, Lando HA, Duval S, Ukestad L, Kodl M, Hirsch AT (2010). "Effectiveness of a smoking cessation program for peripheral artery disease patients: a randomized controlled trial". Journal of the American College of Cardiology. 56 (25): 2105–12. doi:10.1016/j.jacc.2010.07.031. PMID 21144971. Retrieved 2012-11-05. Unknown parameter
|month=ignored (help) - ↑ Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, Watsky EJ, Gong J, Williams KE, Reeves KR (2006). "Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial". JAMA : the Journal of the American Medical Association. 296 (1): 47–55. doi:10.1001/jama.296.1.47. PMID 16820546. Retrieved 2012-11-05. Unknown parameter
|month=ignored (help) - ↑ "JAMA Network | JAMA: The Journal of the American Medical Association | Efficacy of Varenicline, an α4β2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Placebo or Sustained-Release Bupropion for Smoking CessationA Randomized Controlled Trial". Retrieved 2012-11-05.
- ↑ Nides M, Oncken C, Gonzales D, Rennard S, Watsky EJ, Anziano R, Reeves KR (2006). "Smoking cessation with varenicline, a selective alpha4beta2 nicotinic receptor partial agonist: results from a 7-week, randomized, placebo- and bupropion-controlled trial with 1-year follow-up". Archives of Internal Medicine. 166 (15): 1561–8. doi:10.1001/archinte.166.15.1561. PMID 16908788. Retrieved 2012-11-05.
- ↑ Jorenby DE, Leischow SJ, Nides MA, Rennard SI, Johnston JA, Hughes AR, Smith SS, Muramoto ML, Daughton DM, Doan K, Fiore MC, Baker TB (1999). "A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation". The New England Journal of Medicine. 340 (9): 685–91. doi:10.1056/NEJM199903043400903. PMID 10053177. Retrieved 2012-11-05. Unknown parameter
|month=ignored (help)