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Premature atherosclerotic peripheral artery disease: An underrecognized and undertreated disorder with a rising
Anurag Mehta1, Devinder S Dhindsa1, Ananya Hooda1
1Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia.
Insights
Premature peripheral artery disease (PAD) affects individuals under 50. This review covers its increasing prevalence, risk factors, and management strategies for better patient outcomes.
Area of Science:
- Vascular Medicine
- Cardiovascular Research
- Epidemiology
Background:
- Premature atherosclerotic peripheral artery disease (PAD) is diagnosed before age 50.
- Increasing global prevalence and underdiagnosis due to varied symptoms.
- Associated with traditional (smoking, diabetes, hypertension, hyperlipidemia) and non-traditional risk factors (elevated lipoprotein(a), family history, hypercoagulability, inflammation).
Purpose of the Study:
- To review the epidemiology of premature PAD.
- To discuss associated risk factors for early-onset PAD.
- To outline clinical evaluation and management strategies for premature PAD.
Main Methods:
- Literature review of studies on premature PAD.
- Synthesis of epidemiological data.
- Analysis of risk factors and management guidelines.
Main Results:
- Premature PAD presents aggressively with multiple cardiovascular risk factors.
- Patients often have co-existing coronary artery disease.
- Underdiagnosis is common due to heterogeneous symptoms.
Conclusions:
- Effective management focuses on preventing cardiovascular events and limb complications.
- Early identification and aggressive risk factor modification are crucial.
- Comprehensive evaluation and tailored treatment plans improve patient prognosis.
Abstract:
Premature atherosclerotic peripheral artery disease (PAD) of the lower extremities is characterized by disease diagnosis before the age of 50 years. The global prevalence of premature PAD has increased, and the disease is often underdiagnosed given heterogenous patient symptoms. Traditional cardiovascular risk factors like smoking, diabetes, hypertension, and hyperlipidemia as well as non-traditional risk factors like elevated lipoprotein(a), family history of PAD, hypercoagulability, and systemic inflammation are associated with premature PAD. Patients with premature PAD tend to have an aggressive vascular disease process, a high burden of cardiovascular risk factors, and other concomitant atherosclerotic vascular diseases like coronary artery disease. Prevention of cardiovascular events, improvement of symptoms and functional status, and prevention of adverse limb events are the main goals of patient management. In this review, we discuss the epidemiology, risk factors, clinical evaluation, and management of patients with premature PAD.
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