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WASHINGTON, Feb. 8, 2024—According to a new national survey released today by the PAD Pulse Alliance, 70% of Americans are unaware of peripheral artery disease (PAD)—the most common vascular disease in which leg arteries become narrowed, reducing or cutting off blood flow, contributing to 400 amputations performed each day in the United States. The top risk factors for PAD are common chronic health conditions that disproportionately impact underserved communities. Yet among Black and Hispanic adults, nearly 80% report never having a doctor or healthcare provider discuss PAD with them—underscoring the need to start the conversation.

"These new insights are particularly concerning among those most at risk and come at a time when a staggering 1 in 20 Americans over 50 years of age experience PAD," said SCAI President George D. Dangas, MD, PhD, MSCAI. "The survey confirms what we feared: millions don't have the tools they need to help start a conversation with their healthcare providers because patients are unaware of their risks and the common signs and symptoms. That's why we're encouraging anyone with leading risk factors, diabetes, high blood pressure and use of tobacco products, to know your 'three for PAD' and talk to your doctor."

To help educate patients and give them the tools to start the conversation, the PAD Pulse Alliance and its partners published a website and Patient Toolkit, available at PADPulse.org.

The top three risk factors for PAD are diabetes, high blood pressure, and use of tobacco products. People with diabetes are three to four times more likely to suffer from PAD, while 35 to 55% of people with PAD also have high blood pressure. Alarmingly, 80% of patients with PAD are smokers or former smokers.

Data from the PAD Pulse Alliance survey highlights a disconnect among people between the risk factors and their personal perceived risk of PAD. Nearly 75% of Black and Hispanic adults surveyed report having or knowing someone who has diabetes, high blood pressure, or is a smoker, but only 30% believe they could be at risk. This is in stark contrast to real-world impact. Black people are twice as likely to suffer from PAD and up to four times more likely to undergo an amputation compared to white people. Hispanics present with more progressive PAD leading to worse outcomes including greater risk of amputation.

"The disturbing variations in PAD prevalence, treatments and outcomes underscore another perilous consequence of the health equity gap in managing chronic conditions," said Foluso Fakorede, MD, CEO of Cardiovascular Solutions of Central Mississippi, co-chair of the Association of Black Cardiologists PAD Initiative. "It's critical to increase awareness among racial and ethnically marginalized communities and the providers who serve them to close the gap. This campaign is one way we are doing just that, but it will take an ongoing conversation to ensure we're meeting patients where they are with the tools and resources they need."

All too often, signs and symptoms of PAD can go unrecognized or are easily dismissed. Leg pain that occurs while walking and stops with rest is one of the first symptoms of PAD. However, nearly all survey respondents (91%) say they would dismiss pain as just part of getting older.

"Screening for PAD is easy, quick, and non-invasive. Yet, this survey confirmed that critical patient-provider conversations addressing common symptoms aren't happening," said SIR President Alda L. Tam, MD, MBA, FSIR, an interventional radiologist and professor in the Department of Interventional Radiology at the University of Texas MD Anderson Cancer Center in Houston. "If we can educate more people on the risk factors and early warning signs associated with PAD, it's our hope we can foster dialogue earlier between providers and patients to kick off screening and treatment – ultimately preventing amputations and saving lives."

Witnessing increases in amputation rates along with gaps in awareness, four leading heart and vascular medical societies (Association of Black Cardiologists, Society for Cardiovascular Angiography & Interventions, Society of Interventional Radiology, and Society for Vascular Surgery) joined together as the PAD Pulse Alliance to raise awareness about PAD and empower patients to ask their doctors – could it be PAD? The Get a Pulse on PAD campaign is designed to educate people on the risk factors and potential symptoms while encouraging patients to advocate for their health by kicking off the conversation with their doctor.

"The collaboration among these medical societies is a testament to the devastating impact PAD can have on people, families and whole communities if not diagnosed and treated early, and importantly, early treatment usually consists of medication and lifestyle changes," said Joseph L. Mills, MD, DFSVS, President of the Society for Vascular Surgery. "We hope that care teams will continue to collaborate to ensure early and proper diagnosis with the ultimate goal of improving outcomes for patients." 

Key survey highlights

• Nearly 70% of Americans are not familiar with PAD and its devastating risks.
• Nearly all of the survey respondents (91%) would dismiss pain as just part of getting older, but pain in your leg when walking that goes away with rest is one of the first symptoms of PAD.
• Over half (53%) of respondents would wait more than a week with ongoing leg pain before calling their doctor.
• Nearly eight in 10 Black and Hispanic never had a doctor or healthcare provider talk with them about PAD.
• Despite 71% of Black adults having one or more risk factors for PAD or knowing someone with one or more risk factors, 65% report they are at little to no risk at all for developing PAD.
• Three-quarters of Hispanic adults have one or more risk factors for PAD or know someone with one or more risk factors but 70% think they are not at risk for developing PAD.

About the PAD Pulse Alliance survey

PAD Pulse Alliance fielded three surveys to better understand perceptions from the general population, the Black American population, and the Hispanic population.

• General population: Included 1,000 responses from a nationally representative sample over the age of 18. The confidence level for the survey is 95% with a margin of error of ±3.1. 
• Black American population: Included 500 responses from a sample of Black respondents using census data for age and sex balancing. All respondents are over the age of 18. The confidence level for the survey is 95% with a margin of error of ±3.1.
• Hispanic American population: Included 500 responses from a sample of Hispanic respondents using census data for age and sex balancing. All respondents are over the age of 18. The confidence level for the survey is 95% with a margin of error of ±3.1.

About the Get a Pulse on PAD Campaign

Supported by the PAD Pulse Alliance, the Get a Pulse on PAD campaign aims to educate and raise awareness about the risk factors and potential symptoms of PAD – the most debilitating disease that many people have never heard of. We want to empower patients to advocate for their health by kicking off the conversation with their doctor.

The initiative is chaired by prominent experts representing diverse vascular and interventional specialties:

• Foluso Fakorede, MD, CEO of Cardiovascular Solutions of Central Mississippi
• Kumar Madassery, MD, FSIR, director of the Peripheral Vascular Intervention & CLI Program at Rush University Medical Center
• Eric A. Secemsky, MD, MSc, RPVI, FSCAI, director of vascular intervention in the CardioVascular Institute at Beth Israel Deaconess Medical Center
• William Shutze, MD, vascular surgeon at Texas Vascular Associates

For more information, visit PADPulse.org.

About ABC: Founded in 1974, ABC is a nonprofit organization with an international membership of over 2,000 health professionals, lay members of the community (Community Health Advocates), corporate members, and institutional members. The ABC is dedicated to eliminating the disparities related to cardiovascular disease in all people of color.

About SCAI: The Society for Cardiovascular Angiography and Interventions is a professional organization representing more than 4,000 invasive and interventional cardiology professionals in approximately 75 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care.

About SIR: The Society of Interventional Radiology is a nonprofit, professional medical society representing more than 8,000 practicing interventional radiology physicians, trainees, students, scientists and clinical associates, dedicated to improving patient care through the limitless potential of image-guided therapies.

About SVS: The Society for Vascular Surgery (SVS) seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. The organization was founded in 1946 and currently has a membership of more than 6,300. SVS membership is recognized in the vascular community as a mark of professional achievement.