The 2024 multisociety Guideline for the Management of Lower Extremity Peripheral Artery Disease (PAD) recognizes the implementation of the PAD National Action Plan as a top advocacy priority.¹ The PAD National Action Plan outlines six strategic goals to improve awareness, detection, and treatment of PAD nationwide.² The rationale behind developing this plan is that PAD currently poses a substantial global burden, impacting millions of individuals worldwide, which is increasing annually. Because of the aging of the US population, statistics suggest that approximately 19 million people will be affected by PAD by 2050, including approximately 16 million individuals ≥65 years of age.^2,3 However, underdiagnosis of PAD remains a global issue, and limited health care access, particularly in underprivileged communities worldwide, compounds the challenge.⁴ Additionally, a lack of widespread expertise among clinicians in the detection, screening, treatment, and management of PAD further exacerbates delays in diagnosis and worsens overall prognosis.⁵

PAD strains health care delivery systems, patients, and clinicians, and imposes a significant societal burden. Complications, such as amputations, place individuals at risk of job loss and hinder their ability to contribute to society, further amplifying the overall societal burden. These patients require extensive health care services, including orthotics, postamputation health care, and rehabilitation/physical therapy services, which escalate health care costs. All those factors may contribute to the deterioration of their psychological well-being.

The first goal of the PAD National Action Plan is to raise awareness about PAD among the general population.² Many individuals with PAD are asymptomatic or experience subtle symptoms that are often mistaken for normal signs of aging. Improving individual awareness of symptoms of PAD, especially for those at high risk given underlying factors, would facilitate early detection and diagnosis. Improving the understanding of PAD complications and prognosis in the general population would help patients seek medical assistance early when experiencing these symptoms. Education is crucial in communities, particularly those underserved or at higher risk of developing PAD. Health disparities have been recognized in the diagnosis and treatment of PAD; therefore, one of the objectives of this goal is to improve outreach to patients in underserved or underprivileged communities because they are the most affected by PAD. This goal encourages local collaborations to improve community awareness via creation of social groups and awareness campaigns that can be held in local clubs, places of worship, barber shops, and online platforms to help patients in different areas and regions. Increasing public knowledge about risk factors such as smoking, diabetes mellitus, hypertension, and high cholesterol levels is crucial for early management to aid in risk-factor modification.

The PAD National Action Plan emphasizes multidisciplinary professional education for health care professionals who see patients with PAD. A comprehensive educational curriculum that integrates multiple disciplines should be created and distributed widely. It is essential to incorporate standardized vascular content into certification programs or standardized training programs for physicians (including podiatrists), nurses, advanced practice providers, nutritionists, vascular technologists, and other allied health care professionals. This approach includes advocating for comprehensive treatment strategies that encompass lifestyle modifications, medications, supervised exercise programs, psychological counseling, and invasive procedures. This education ensures that all professionals possess a common foundational knowledge of PAD through disseminating clinical guidelines and best practices, which will standardize care across diverse health care settings and improve patient outcomes.

Improving public outcome reporting and public health interventions is goal number four on the PAD National Action Plan, as this is thought to reduce the rates of nontraumatic lower extremity amputations related to PAD.² Goal number 5 emphasizes advancing research and innovation,² with the aim of supporting collaborative research efforts focused on better understanding the pathophysiology of PAD, its risk factors, and its treatment outcomes. By promoting research initiatives and clinical trials, the plan seeks to identify new therapeutic strategies, diagnostic tools, approaches to personalized medicine, and patient-tailored/centered care for patients with PAD. This research-driven approach not only fosters innovation but also aims to address health care disparities and improve the quality of care for individuals affected by PAD across diverse populations.

Collaboration and partnership are fundamental principles of the PAD National Action Plan. Engaging stakeholders from government agencies, health care organizations, professional societies, patient advocacy groups, and industry enables a coordinated approach to tackling the challenges posed by PAD. By fostering partnerships, sharing data, and leveraging resources, stakeholders can collectively develop and implement strategies that address disparities in PAD awareness, access to care, and health outcomes among diverse populations.

In conclusion, the PAD National Action Plan represents a concerted effort to improve care for PAD comprehensively. By prioritizing awareness, prevention, and management strategies, the PAD National Action Plan aims to reduce the burden of PAD on individuals, families, communities, and society. Through collaboration, innovation, and evidence-based practices, clinicians can work toward achieving better outcomes for patients with PAD and improving the quality of life for millions affected by this prevalent and often under-recognized vascular condition.

References

1. Gornik HL, Aronow HD, Goodney PP, et al.; Writing Committee Members. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2024;83:2497-604.
2. American Heart Association. PAD National Action Plan (AHA website). 2022. Available at: https://professional.heart.org/-/media/PHD-Files-2/Science-News/p/PAD-National-Action-Plan.pdf. Accessed 10/29/2024.
3. GBD 2019 Peripheral Artery Disease Collaborators. Global burden of peripheral artery disease and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Glob Health 2023;11:e1553-e1565.
4. Bauersachs R, Zeymer U, Brière JB, Marre C, Bowrin K, Huelsebeck M. Burden of coronary artery disease and peripheral artery disease: a literature review. Cardiovasc Ther 2019;Nov 26:[ePub ahead of print].
5. Campbell A, Alslaim H, Duson S, Rowe VL. Educating trainees to treat peripheral arterial disease: challenges and opportunities. Ann Vasc Surg 2024;107:101-4.