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Few Americans Know of Leg Artery Danger
Date:9/19/2007

8 percent associated it with an increased risk of heart attack, and just 14 percent linked it with amputation and death.

That's no big surprise, Murphy said, since "the link between PAD and heart attacks and stroke is just becoming disseminated among primary-care physicians."

Relatively few family doctors routinely perform the basic diagnostic test for PAD, called the ankle-brachial index, he said. Blood pressure is measured in the arm and at the ankle, with the measurements repeated at both sites after five minutes of walking on a treadmill. Lower pressure at the ankle indicates PAD. The lower the ankle-brachial index, the greater the danger.

"The test is not often done in a primary-care physician's office," Murphy said. "It is not reimbursed under Medicare unless there are symptoms, and it is hard to ask physicians to do a test unless they are reimbursed. We are trying to get support for Medicare to reimburse for it as a diagnostic test."

Diagnosis of PAD indicates the need for attention to the well-known risk factors for arterial blockage elsewhere in the body, such as smoking, high blood pressure, cholesterol levels and lack of exercise, said Dr. Alan T. Hirsch, a professor of epidemiology and community health at the University of Minnesota, and another author of the report.

Lack of awareness means that even adults who have leg pains or other symptoms of PAD are not aware of its dangers, Hirsch said. "At a time when the public is bombarded with health messages, it would seem wise for those with one of the single most common cardiovascular diseases to be aware of the risk," he said.

The survey also shows that physicians are not doing enough about awareness of PAD risk, Hirsch said. While 26 percent of those in the survey who were aware of PAD said they got information from broadcast media such as television, only 19 percent reported first hearing about PAD from a health-care provider.

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