Published Online
on September 17, 2007

A more recent version of this article appeared on October 30, 2007

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Gaps in Public Knowledge of Peripheral Arterial Disease. The First National PAD Public Awareness Survey

Alan T. Hirsch MD^*, Timothy P. Murphy MD, Marge B. Lovell RN, Gwen Twillman , Diane Treat-Jacobson PhD, RN, Eileen M. Harwood PhD, Emile R. Mohler III MD, Mark A. Creager MD, Robert W. Hobson II MD, Rose Marie Robertson MD, W. James Howard MD, Paul Schroeder MA, Michael H. Criqui MD, MPH, for the Peripheral Arterial Disease Coalition

From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (A.T.H., E.M.H.); Minneapolis Heart Institute Foundation, Minneapolis, Minn (A.T.H.); Rhode Island Hospital and Lifespan, Inc, Providence (T.P.M.); Division of Vascular Surgery, London Health Sciences Center, London, Ontario, Canada (M.B.L.); Peripheral Arterial Disease Coalition, Washington, DC (G.T.); University of Minnesota School of Nursing, Minneapolis (D.T.-J.); University of Pennsylvania, Philadelphia (E.R.M.); Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass (M.A.C.); University of Medicine and Dentistry of New Jersey, New Jersey Medical School, and St Michael’s Medical Center, Newark, NJ (R.W.H.); American Heart Association, Dallas, Tex (R.M.R.); Washington Hospital Center, Washington, DC (W.J.H.); Schulman, Ronca & Bucuvalas, Inc, Silver Spring, Md (P.S.); and Department of Family and Preventive Medicine, University of California, San Diego (M.H.C.).

^* To whom correspondence should be addressed. E-mail: hirsc005{at}umn.edu.

Background—Lower-extremity peripheral arterial disease (PAD) is associated with decreased functional status, diminished quality of life, amputation, myocardial infarction, stroke, and death. Nevertheless, public knowledge of PAD as a morbid and mortal disease has not been previously assessed.

Methods and Results—We performed a cross-sectional, population-based telephone survey of a nationally representative sample of 2501 adults >50 years of age, with oversampling of blacks and Hispanics. The survey instrument measured the demographic, risk factor, and cardiovascular disease characteristics of the study population; prevalent leg symptoms; PAD awareness relative to atherosclerosis risk factors and other cardiovascular and noncardiovascular diseases; perceived causes of PAD; and perceived systemic and limb consequences of PAD. Respondents were 67.2±12.6 years of age with a high prevalence of risk factors but only a modest burden of known coronary or cerebrovascular disease. Twenty-five percent of respondents expressed familiarity with PAD, a rate significantly lower than that for any other cardiovascular disease or atherosclerosis risk factor. Within the "PAD-aware" cohort, knowledge was poor. Half of these individuals were not aware that diabetes and smoking increase the risk for PAD; <1 in 4 knew that PAD is associated with increased risk of heart attack and stroke; and only 14% were aware that PAD could lead to amputation. All knowledge domains were lower in individuals with lower income and education levels.

Conclusions—The public is poorly informed about PAD, with major knowledge gaps regarding the definition of PAD, risk factors that lead to PAD, and associated limb symptoms and amputation risk. The public is not aware that PAD imposes a high short-term risk of heart attack, stroke, and death. For the national cardiovascular disease burden to be reduced, public PAD knowledge could be improved by national PAD public education programs designed to reduce critical knowledge gaps.

Key words: claudication • myocardial infarction • peripheral vascular disease • prevention • risk factors

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