Public Health Burden of CAD/PAD

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Presentation transcript:

Public Health Burden of CAD/PAD Ischemic Heart Disease >110 million prevalent cases globally ~ 9 million deaths >6 million prevalent cases in North America >500,000 deaths Peripheral Artery Disease Most prevalent cardiovascular condition globally JACC 2017;70:1-25

Risk Factors for CAD and PAD PAD and CAD Risk Among Smokers Risk Factors Older age Diabetes Mellitus Tobacco Use Hyperlipidemia Hypertension Family History of CAD/PAD Atherosclerosis in other vascular bed Chronic Kidney Disease PAD CAD EHJ 1999;20:344-353

When to Screen for PAD? Increased Risk  Comprehensive History & Physical Assess for exertional leg symptoms, rest pain, non-healing wounds Palpate lower extremity pulses, auscultate for femoral bruits Inspect the legs and feet Positive history/exam finding  order resting Ankle-Brachial Index (ABI) ABI ≤ 0.90  abnormal ABI 0.91-0.99  borderline ABI 1.00-1.40  normal ABI > 1.40  non-compressible Check Toe-Brachial Index (TBI) JACC 2017;69:e71-126