Special Report Peripheral Arterial Disease: Lack of Awareness in Canada The First Canadian P.A.D. Public Awareness Survey Peripheral Arterial Disease:

Special Report

Peripheral Arterial Disease: Lack of

Awareness in Canada

The First Canadian P.A.D. Public Awareness

Survey

Peripheral Arterial Disease: Lack of Awareness in Canada. Canadian Journal of Cardiology, 2009, in press

Contributors

Marge B. Lovell, RNKenneth Harris MDThomas Forbes MDBeth Abramson MD

Gwen TwillmanPaul Schroeder, MA

Michael H. Criqui, MD, MPH Emile R. Mohler, III, MD

Alan T. Hirsch, MD

on behalf of the Peripheral Arterial Disease Coalition

National P.A.D. Public Awareness Survey Background

• Lower extremity peripheral arterial disease (P.A.D.) is common, affecting up to 12% to 29% of the elderly and approximately 800,000 Canadians.

• Intermittent claudication is the most frequent symptom of P.A.D. and impairs quality of life and functional status.

• Individuals with P.A.D. suffer a 5-fold increased relative risk of a heart attack and stroke and total mortality that is 2-3 fold greater than those without P.A.D.

• Individuals with P.A.D. suffer combined annual rates of heart attack, stroke, and hospitalization that are comparable to, or greater than, rates observed in individuals with established coronary artery disease or stroke.

• … but if the public is not aware of this risk, how can the risk be lowered?

National P.A.D. Public Awareness Survey Objectives

• Obtain baseline data to quantify public knowledge of the causes (risk factors), symptoms, and ischemic risks to life and limb of P.A.D.

• Results intended to serve as a benchmark so that improvements in awareness can be documented over time.


National P.A.D. Public Awareness Survey Methods

• 10-minute telephone survey used a Random Digit Dialing (RDD) sampling procedure to draw a national probability sample

• Survey administered to: National cross-section of 501 Canadians ages 50+ years

• Conducted from 6/5/2006 to 7/5/2006

• Interviews were conducted in English and French

• Results were weighted by age and gender to reflect 2006 Canadian census estimates


Total Sample, n (%) 501 (100)

Gender Male

Female

233 (46.4)

268 (53.6)

Age 50-59

60-69

70-79

80+

209 (41.6)

136 (27.2)

103 (20.6)

53 (10.5)

Race White

Black

Aboriginal

Asian

Other

466 (93)

3 (0.7)

8 (1.6)

10 (1.9)

8 (1.6)

The Survey Population Demographics


Total Sample, n (%) 501 (100)

Education ≤ High School

> High School

301 (60.1)

194 (38.7)

Income < $40,000

≥ $40,000

233 (46.6)

192 (38.3)




Risk Factors and CV DiseasesHigh blood pressure 43.4

High cholesterol 36.7

Diabetes 12.0

Smoking History

Current 18.2

Past 40.5

Never 41.1

Chest pain or angina 18.2

Heart attack 10.0

Coronary bypass surgery or angioplasty 7.6

Stroke 4.2

Mini-stroke or TIA 5.8

Carotid artery surgery or stenting 1.8

P.A.D. 0

PercentageRisk Factor or CVD


P.A.D. Symptoms

22%

19%

30%

13%10%

1%

0%

5%

10%

15%

20%

25%

30%

35%

Persistent orrecurring pain in

legs

Frequent pain inlegs w hen

w alking

Frequent pain inlegs w hen sitting

Frequent pain inlegs w henelevated

Wound or sore onfoot that w ould

not heal

Any of these

Do you currently have ___ ?


Per

cent

age

of r

espo

nden

ts

Key Findings

Two Out of Three Adults Surveyed Are Not Familiar

with P.A.D.

P.A.D. AwareNot Aware

P.A.D. Aware(36%)Not Aware

of P.A.D.(64%)

How familiar are you with P.A.D.:very familiar, somewhat familiar, not too familiar or not at all familiar?

“P.A.D. Aware” defined by “somewhat” or “very familiar” responses


P.A.D. Awareness Is Markedly Lower Than Other Cardiovascular Diseases and Risk

FactorsHow familiar are you with the following conditions: very familiar, somewhat familiar, not too familiar or not at all familiar?

0 20 40 60 80 100

High blood pressure

Stroke

Coronary artery disease

Congestive heart failure

P.A.D.

Percentage very or somewhat familiar

80

74

79

48

72

36

Diabetes

High cholesterol


51

P.A.D. Awareness by Age and Gender

23

How familiar are you with P.A.D.:very familiar, somewhat familiar, not too familiar or not at all

familiar?


05

10152025303540

Male Female

31

32

33

34

35

36

37

50-69 years 70+ years

% v

ery

or

som

ewh

at f

amili

ar

33

3732

39

% v

ery

or

som

ewh

at f

amili

ar

P.A.D. Awareness by

Education and Income

0

10

20

30

40

50

<High School >High School

% v

ery

or

som

ewh

at f

amili

ar

29

4632

23

How familiar are you with P.A.D.:very familiar, somewhat familiar, not too familiar or not at all

familiar?


05

10152025303540

< $40K > $40K

% v

ery

or

som

ewh

at f

amili

ar

3140

Perceived Causes of P.A.D. Among Those “P.A.D. Aware”

Does ____ increase the risk of getting P.A.D. not at all, a little, some, a moderate amount or a lot.

Combined Responses: A Lot & Moderate Amount

0 20 40 60 80

Overweight

Cigarette smoking

Lack of exercise

Diabetes

High cholesterol

Heart attack or stroke

Personal history MI/stroke

Drinking alcohol

Percentage

58

57

51

55

49

51

44

36


High blood pressure

37

Perceived Consequences of P.A.D.Among Those “P.A.D. Aware”

0

20

40

60

80

100

Stroke

Death

Heart Attack

Amputation

Other

Disability

Blood Clot

% o

f “P

.A.D

. Aw

are

” re

sp

on

de

nts

21 12

7 6

Based on what you know or have heard, what can P.A.D. lead to if not treated?

21 20

2

Few Canadians First Learn About P.A.D. through Health Care Providers

Television

Magazine/NewspaperRadio

Internet

Health CareProviderFamily/Friends

Other

At Work

TV(28%)

Magazine/Newspaper

(15%)

Family& Friends

(18%)

Health Care Provider

(19%)

Radio(1%)

Internet(3%)

Other(15%)


At Work (5%)

Conclusions

• Few (about two in three) Canadians are aware of P.A.D.

• Those Canadians at risk for P.A.D. do not know its causes and thus cannot take steps to prevent it.

• Few Canadians know that having P.A.D. markedly increases one’s short-term risk for heart attack, stroke, amputation and death.

• Those who are aware of P.A.D. rarely first learn about it from health care providers.

Conclusions

• P.A.D.-related knowledge is far below that of other comparable or lower risk cardiovascular diseases.

• These findings reinforce the need for national educational efforts on P.A.D.

• Health professionals, the media, the healthcare industry, and government agencies share a responsibility to work together to inform the public about this common cardiovascular disease.

The P.A.D. Coalition

• The P.A.D. Coalition aims to deliver consistent, evidence-based P.A.D. messages to the public and the health care community.

• New tools are available to help medical practices, hospitals, health plans and health systems educate their patients and clinicians about P.A.D.

• Visit www.PADCoalition.org

Special Report Peripheral Arterial Disease: Lack of Awareness in Canada The First Canadian P.A.D. Public Awareness Survey Peripheral Arterial Disease:

Documents

lack of awareness

press slide

canadian journal of

canadian census

minute telephone survey

md alan

public knowledge

relative risk