ABC of arterial and vascular disease: Secondary prevention of peripheral vascular disease

doi:10.1136/bmj.320.7244.1262

BMJ 2000;320:1262-1265 ( 6 May )

Clinical review

ABC of arterial and vascular disease

Secondary prevention of peripheral vascular disease

Sean Tierney, Fiona Fennessy, David Bouchier Hayes.

The first 150 words of the full text of this article appear below.

Most patients with peripheral vascular disease may be reassured that, with respect to their legs, the condition usually runsa benign course. Less than one third of patients will requireany surgical or radiological intervention and only 5% will haveamputation. However, peripheral vascular disease is an independentpredictor of increased risk of cardiovascular death. Half of patientspresenting with peripheral vascular disease have symptoms of coronaryartery disease or electrocardiographic abnormality, 90% have abnormalitieson coronary angiography, and 40% have duplex evidence of carotidartery disease.

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Symptomatic peripheral vascular disease carries at least a 30% risk of death within five years and almost 50% within 10 years,primarily due to myocardial infarction (60%) or stroke (12%).The risks are more than doubled in patients with severe disease(requiring surgery), but even asymptomatic patients (ankle brachialpressure index <0.9) have a twofold to fivefold increased riskof fatal or non-fatal cardiovascular . . . [Full text of this article]

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