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Smokers with peripheral artery disease need more help to kick the habit

October 03, 2018

DALLAS, Oct. 3, 2018 -- While many people with peripheral artery disease (PAD) smoke, few receive proven smoking cessation strategies from their doctor, according to new research in the Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Worldwide, 202 million adults are affected by peripheral artery disease which is a narrowing of the arteries serving the legs, stomach, arms and head. Peripheral artery disease most commonly affects arteries in the legs.

"Smoking is the single most important risk factor for development and progression of peripheral artery disease," said study author Krishna K. Patel, M.D., M.Sc., a cardiology fellow at the University of Missouri-Kansas City, Saint Luke's Mid America Heart Institute. "More importantly, it is modifiable. Smoking cessation is the cornerstone for managing patients with this disease."

Researchers studied the smoking behaviors of more than 1,200 patients who had gone to specialty vascular clinics to be treated for peripheral artery disease. Patients were experiencing new or worsening leg pain or cramping when exercising because muscles in the legs or other limbs were not getting enough blood flow (claudication).

Researchers found:
  • 37 percent of peripheral artery disease patients were active smokers.
  • 16 percent received a referral to a smoking cessation counseling program and 11 percent received drug treatment or nicotine replacement therapy.
  • 36 percent of peripheral artery disease smokers who quit relapsed within a year.
  • 72 percent of active peripheral artery disease smokers continued smoking after a year.
  • Patients' chances of quitting were highest within the first three months after visiting their specialty providers.
"Many patients continue smoking or relapse after they attempt to quit. Doctors taking care of these patients need to be aware of this and provide consistent, ongoing cessation support to their smoking patients at every opportunity they get with them," Patel said.

Patients should not be afraid to reach out to their doctors, friends and family and other cessation support services if they need additional help to quit or to prevent relapses."

The study excluded patients without symptoms related to peripheral artery disease or those whose disease was not severe enough to require a specialist or who may have received care at their primary care physicians' offices.

"The next step is to identify the barriers in providing adequate smoking cessation support for PAD patients in order to identify what works and what could be improved upon," Patel said.
-end-
Co-authors are Philip G. Jones, M.S.; Edward F. Ellerbeck, M.D., M.P.H.; Donna M. Buchanan, Ph.D.; Paul S. Chan, M.D., M.Sc.; Christina M. Pacheco, J.D., M.P.H.; Gregory Moneta, M.D.; John A. Spertus, M.D., M.P.H.; and Kim G. Smolderen, Ph.D. Author disclosures are on the manuscript.

Additional Resources:Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke - the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

American Heart Association

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