Peripheral artery disease (PAD) represents a significant health crisis in the United States, affecting an alarming number of adults, particularly those over the age of 50. In a groundbreaking study conducted by Nriagu et al., published in the Journal of General Internal Medicine, researchers delve into the prevalence, treatment patterns, and outcomes associated with PAD in US primary care settings from 2018 to 2022. This large-scale, retrospective analysis leverages electronic health records (EHRs) to provide insights into how PAD is managed across countless practices, thereby addressing a crucial gap in our understanding of this debilitating condition.
Peripheral artery disease occurs when the arteries supplying blood to the limbs become narrowed or blocked due to atherosclerosis, leading to reduced blood flow. This impairment can cause significant pain, mobility issues, and, in severe cases, can lead to limb ischemia or even amputation. Yet, despite its serious implications, PAD remains underdiagnosed and undertreated. The findings from Nriagu et al. shed light on the intricacies surrounding this notion, illuminating how primary care practices approach diagnosis and management.
In the analyzed data, researchers found that among patients diagnosed with PAD, a significant percentage displayed comorbidities, including diabetes, hypertension, and hyperlipidemia. These coexisting conditions complicate the management of PAD and highlight the need for a multifaceted approach to treatment. Additionally, the presence of these comorbidities often exacerbates the symptoms of PAD, leading to a higher burden on both patients and healthcare systems, making it imperative to assess how these factors interplay within primary care practices over the years explored.
Nriagu and colleagues reported that the diagnostic methods employed in primary care vary considerably, leading to inconsistencies in how PAD is identified. While some practices utilized ankle-brachial index testing, which measures blood flow, others relied on clinical evaluations alone, such as assessing patient history and symptoms. This inconsistency raises questions about the standardization of PAD diagnoses and calls for the establishment of best practices in primary care settings to ensure that patients receive timely and accurate diagnoses.
The researchers also assessed treatment modalities offered to patients diagnosed with PAD. They found that while lifestyle modifications, including exercise and dietary changes, were frequently recommended, pharmacologic therapy was prescribed less often than ideal. Statins and antiplatelet agents are imperative in managing PAD due to their role in reducing cardiovascular events. However, the study indicated that not all eligible patients were placed on these critical medications, emphasizing an opportunity for improvement in therapeutic strategies within primary care.
Patient follow-up emerged as another critical aspect of PAD management highlighted by Nriagu et al. Many patients were observed to have irregular follow-up visits, thus diminishing the potential for continuous care and optimization of treatment plans. Regular follow-up appointments are essential to monitor disease progression, modify treatment as necessary, and reinforce education regarding the management of PAD, thereby improving overall health outcomes for these patients.
Another revealing aspect of the study is the varying degrees of awareness and understanding of PAD among primary care providers. Training and knowledge gaps mean that some physicians may not prioritize PAD management adequately within their practices, leading to delayed diagnoses and a lack of effective treatment. Addressing these educational deficiencies is vital, as an informed healthcare workforce can significantly enhance the care delivered to patients with PAD.
The social determinants of health also play a critical role in PAD outcomes. Factors such as socioeconomic status, education level, and access to healthcare services can influence both the prevalence of PAD and the effectiveness of care provided. Nriagu et al. emphasized the need for a holistic view of patient health that encompasses these social determinants, advocating for healthcare systems to develop frameworks that address these issues more comprehensively.
One concerning finding was the disparity in PAD management among different demographic groups. The analysis showed that certain populations, particularly racial and ethnic minorities, faced higher rates of PAD but received less aggressive treatment. This raises alarms about equity in healthcare and the importance of targeted interventions that consider racial disparities impacting patient care. By identifying and addressing these discrepancies, the medical community can work towards more equitable healthcare delivery.
The timeline of the study, spanning from 2018 to 2022, captures a unique period marked by the global COVID-19 pandemic, which altered healthcare delivery significantly. The effects of COVID-19 on care systems, access to services, and patient behaviors cannot be understated. Nriagu et al. provide insights into how the pandemic may have shifted attention away from chronic disease management, including PAD, warranting further investigation into the long-term consequences.
Future research directions should focus on longitudinal studies to evaluate the effectiveness of interventions tailored to improve PAD management in primary care settings. Such studies could explore the integration of technology into monitoring and treating PAD, as telemedicine and mobile health applications gain prominence in healthcare. These innovations may provide novel avenues for supporting patients in their self-management efforts, fostering engagement, and ultimately improving outcomes.
In conclusion, the study by Nriagu et al. significantly contributes to our understanding of peripheral artery disease within the context of US primary care. By elucidating various aspects of PAD management—from diagnosis to treatment—this research not only highlights the challenges that providers face but also underscores the critical need for enhanced education, standardized practices, and equitable care. This call to action should resonate throughout the healthcare community, motivating changes that prioritize patient wellbeing in the face of this grave health issue.
As the medical landscape evolves, it remains essential to revisit and refine our approaches to managing chronic diseases such as PAD. Only through continued research and commitment can we hope to reduce the burden of this disease, improving the quality of life for millions of individuals affected by it. The study by Nriagu et al. serves as a stepping stone in this journey, charting a path towards more informed, equitable, and effective care for patients with peripheral artery disease.
Subject of Research: Peripheral artery disease in US primary care practices
Article Title: Peripheral Artery Disease in US Primary Care Practices: A Retrospective EHR-Based Analysis from 2018 to 2022
Article References:
Nriagu, V.C., Hao, Â ., Kamdar, N.S. et al. Peripheral Artery Disease in US Primary Care Practices: A Retrospective EHR-Based Analysis from 2018 to 2022.
J GEN INTERN MED (2025). https://doi.org/10.1007/s11606-025-10050-6
Image Credits: AI Generated
DOI: https://doi.org/10.1007/s11606-025-10050-6
Keywords: Peripheral artery disease, primary care, EHR, patient management, comorbidities, healthcare disparities.
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