New study finds peripheral artery disease often underdiagnosed and undertreated; opportunity to improve treatments, lower death rates

(Press-News.org) A new Intermountain Health study finds that peripheral artery disease, a condition that affects more than 10 million Americans over the age of 40, is often underdiagnosed and undertreated, with fewer women getting guideline-directed medical therapy than men.

As a result, combined with this highly debilitating disease, patients with peripheral artery disease have a more than 50 percent chance of dying from the condition.

Peripheral artery disease affects nearly 10 percent of the US population. It occurs when the arteries that carry blood to the legs and arms become narrowed or blocked by plaque buildup, leading to reduced blood flow.

As one of the major conditions that comprise atherosclerotic cardiovascular disease, peripheral artery disease the third leading cause of death from atherosclerotic disease.

“In our study, we found a high rate of non-treatment of peripheral artery disease along with higher levels of mortality in these patients,” said Viet T. Le, DMSc, MPAS, PA-C, primary investigator of the study and associate professor of cardiovascular research at Intermountain Health. “Based on our findings, we think health systems can do a better job at screening patients for peripheral arterial disease and treating them for it. These findings represent an opportunity to improve and implement systems of care, especially for women.”

The Intermountain Health study findings were presented at the American College of Cardiology’s annual scientific sessions conference in Chicago on Sunday, March 30, 2025.

In the study, researchers identified 7,522 patients who had a symptomatic peripheral artery disease diagnosis at Intermountain Health facilities between January 2006 and December 2021 and were seen once in follow-up within at least 18 months of their initial appointment.

Of that group, 38 percent were women and 62 percent men.

Researchers then looked at whether each patient was treated with the guideline-directed medical therapies of an antiplatelet, statin, and other applicable treatments, and their subsequent risk of having either a major cardiac event, like heart attack, stroke or death, or major limb amputation.

Researchers found that only 29.6 percent of women and 33.5 percent of men received all applicable optimal guideline-directed care, with women having similar rates of referrals to specialists but higher rates to primary care providers.

Women were also slightly less likely to suffer a major cardiac event or limb amputation than men. They also found that patients in the study, regardless of their gender, had a 50 percent chance of dying, Le said.

“Every single person in these groups should have at least received antiplatelet therapy and statin. Instead, only about one in three did, which demonstrates the need to enhance methods to identify and treat peripheral artery disease,” said Le.

These results aren’t necessarily because clinicians don’t care or are not aware of guidelines, he added. Instead, the low rate of prescribing is most likely due to significant challenges in identifying and treating peripheral arterial disease versus other kinds of atherosclerotic disease.

For example, he said, a patient complaining of leg pain can be seen as having a vague complaint, one possibly caused by a range of health or medical conditions. Plus, leg pain can be treated by different types of clinicians, and they may not be up to date on peripheral artery disease or the best possible treatments for it.

Cardiologists may also focus on treating heart disease or preventing stroke, and believe these measures also address peripheral arterial disease, when patients should be screened and treated specifically for that condition, noted Le.

“We can certainly do a better job of screening for peripheral arterial disease and treating it as its own condition,” said Le. “We should not be seeing a 50% death rate among these patients. With development and implementation of better disease screening and treatment monitoring, we can increase appropriate treatment for these patients, and lower death rates.” 

Symptoms of peripheral artery disease often include cold feet, aching or cramping in the feet during activity, and leg ulcers. While anyone can develop peripheral artery disease, the risk for the condition increases as people age, and in the United States, it more frequently occurs in people over 65.

While peripheral arterial disease cannot be cured, lifestyle changes, medication, and other treatments, including surgical procedures, can reduce symptoms, improve the quality of life for patients, and help slow or prevent the progression of the disease.

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