Abstract 20698: Awareness of Peripheral Arterial Disease and Cardiovascular Risk Reclassification Among Hispanic Women
Background: Although peripheral arterial disease (PAD) has been classified as a coronary heart disease (CHD) risk equivalent and a marker of increased mortality, it is infrequently recognized. Data on awareness of PAD in Hispanic women is limited. The aims of the study were to determine the predictors and level of awareness of PAD in free-living Hispanic women and to reclassify their cardiovascular risk after inclusion of the diagnosis of PAD.
Methods: In a cohort of 181 Hispanic women diagnosed with PAD using non-invasive tests performed in community centers, symptoms and awareness of the disease were investigated by a face to face interview conducted previous to the vascular tests. Demographic and socioeconomic data were obtained and used in logistic regression analyses as predictors of PAD awareness. Cardiovascular risk classification based on the Framingham risk score and the Adult Treatment Panel III guidelines was performed before and after the diagnosis of PAD was established by vascular tests.
Results: Only 6% (11/181) of the Hispanic women were aware of a diagnosis of PAD. Median [interquartile range (IQR)] age was 77 (74-83) years for women aware of PAD and 72 (66-79) years for women unaware of PAD (P=.09). The median (IQR) 10-year CHD risk was 27% (8-30) for PAD-aware women and 11% (5-17) for PAD-unaware women (P<.01). Although 33% of women with PAD had typical leg pain, 88% of them did not have a previous diagnosis of PAD. Logistic regression analyses did not identify any significant association between socio-economic factors and PAD awareness. After a diagnosis of PAD was established by non-invasive tests, 43 of the 181 Hispanic women (25.3%) initially classified in the low or intermediate CHD risk categories were reclassified as of high risk.
Conclusions: Among Hispanic women with PAD, awareness of the disease is remarkably low, even among those with typical leg pain. Socioeconomic factors intrinsic to this population are not associated with the level of awareness, suggesting that the disease is under-detected in part because of deficiencies in its diagnosis by health care providers. A significant proportion of Hispanic women unaware of PAD may have lost the opportunity of a correct CHD risk classification and risk factor modification.
- © 2010 by American Heart Association, Inc.