Groundbreaking guidelines promote early detection

December 06, 2005

More than 12 million Americans suffer from peripheral arterial disease (PAD), prompting the American College of Cardiology (ACC) and the American Heart Association (AHA) to release today the groundbreaking Peripheral Arterial Disease Guidelines to help physicians and all healthcare professionals better treat this alarmingly common condition.

PAD is generally defined as diseases of the arteries that supply blood to the arteries outside the heart, including those that supply the legs, feet, kidneys, and intestines. These arterial diseases can impair physical health by diminishing an individual's ability to walk. PAD can lead to amputation of the extremities, rupture of an aortic aneurysm, severe hypertension, kidney failure, as well as contribute to current rates of heart attack, stroke, and cardiovascular death.

The new Guidelines, representing best practices for managing diseases of the aorta--the body's main artery--and the arteries that supply blood to the legs, feet, kidneys, and intestines, were developed in collaboration with and approved by the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine and Biology, and the ACC/AHA Task Force on Practice Guidelines.

"These Guidelines provide a concise diagnostic and treatment guidebook for patients suffering from PAD and for physicians, physicians assistants, nurse practitioners, and nurses who are now offering care to treat them," said Alan T. Hirsch, M.D., F.A.C.C., chairman of the writing committee. "Our important collaborations with our professional partners in SVMB, SIR, SVS and SCAI make these Guidelines more valuable to all practicing health professionals. We have provided access to the best available evidence that can guide best care. A key source of the power of these recommendations is that they are so broad-based in their origin from every vascular specialty, as they attempt to reach a broad-based audience of clinicians. Everyone can use these Guidelines and a large segment of the public can benefit from them."

The PAD Guidelines strongly emphasize the fact that early detection and treatment of peripheral arterial disease can prevent disability and save lives.

"We're saying to physicians for the first time, 'Don't wait for the patient to complain to you about symptoms that they may not appreciate as hallmark signs of poor health. Ask specific questions to define high-risk groups, and initiate early therapy to maintain functional independence and decrease the risk of heart attack, stroke, and death,'" said Dr. Hirsch, an associate professor of epidemiology, medicine, and radiology at the University of Minnesota and director of Abbott Northwestern's Vascular Center in Minneapolis.

A driving force behind the Guidelines was recognition that a wide range of physicians treat peripheral arterial disease, and each brings a different set of tools and knowledge to the task, depending on background and training.

"All physicians who treat these conditions need to be aware of the latest information on diagnosis and management," said Dr. Norman R. Hertzer, emeritus chairman of the Department of Vascular Surgery at the Cleveland Clinic Foundation, Cleveland, Ohio. "These Guidelines present that information in an objective and dispassionate fashion."

Indeed, the guidelines committee took a time-tested approach to analyzing thousands of scientific studies, giving the greatest weight to well-designed randomized clinical trials, but also taking into account smaller studies and expert opinion as needed.

"We have hammered out, to the best of our abilities, recommendations for clinical practice, but we've also been very clear about the relative strengths and weaknesses of each recommendation," said Dr. Ziv J. Haskal, a professor of radiology and surgery, and director of the Division of Vascular and Interventional Radiology at New York-Presbyterian Hospital/Columbia University Medical Center, New York City. "These grayer areas mark some of the most important opportunities for future research."

Highlights of the guidelines include:The Guidelines have been developed not just for specialists who perform the complex procedures used in the treatment of peripheral arterial disease, but also for primary care physicians, nurse practitioners, and physician assistants, all of whom make the initial diagnosis and initiate therapy.

"These Guidelines provide the busy practitioner with a series of signposts to mark the pathway to excellent vascular care," Dr. Hirsch said.

The PAD Guidelines were also 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 the Vascular Disease Foundation.
-end-
The American College of Cardiology, American Heart Association and all other endorsing organizations of the Guidelines are partners in the PAD Coalition, a consortium of 38 health organizations, professional societies and government agencies that have united to raise public and clinician awareness of PAD.

The full text of the Guidelines will be published online at www.acc.org and www.heart.org. An executive summary of the Guidelines will be published in the Journal of the American College of Cardiology and in Circulation: Journal of the American Heart Association.

About the American College of Cardiology:
The American College of Cardiology, a 33,000-member nonprofit professional medical society and teaching institution, is dedicated to fostering optimal cardiovascular care and disease prevention through professional education, promotion of research, leadership in the development of standards and guidelines, and the formulation of health care policy.

About the American Heart Association:
Since 1924 the American Heart Association has helped protect people of all ages and ethnicities from the ravages of heart disease and stroke. These diseases, the nation's No. 1 and No. 3 killers, claim more than 930,000 American lives a year. The association invested more than $473 million in fiscal year 2004-05 for research, professional and public education, advocacy and community service programs so people across America can live stronger, longer lives.

Authors of the Guidelines are available for interviews.

American College of Cardiology

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.