Creager To Call On Profession To Increase Awareness, Treatment For PAD


on – Mark A. Creager, MD, FAHA

Mark A. Creager, MD, FAHA, will urge investigators and clinicians to expand efforts to address the epidemic of peripheral artery disease in his American Heart Association presidential address Sunday.

Creager’s 20-minute address — “The Crisis of Vascular Disease and the Journey to Vascular Health” — officially kicks off the association’s 2015 Scientific Sessions at 1 p.m. in Hall D.

Creager will remind attendees that PAD is not simply a disease of the legs, but a clinical manifestation of a systemic disease that often coexists with coronary artery disease and cerebrovascular disease.

“The risk of death is at least double for patients with PAD compared to patients who do not have it,” said Creager, director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center and professor of medicine at the Geisel School of Medicine at Dartmouth in Lebanon, New Hampshire. “And the risks of myocardial infarction, stroke and cardiovascular death among people with PAD are at least as great as in those patients who have already had a heart attack or stroke.”

Physicians often fail to diagnose or adequately treat PAD, Creager said.

“In one survey, physicians were aware that their patients had PAD only 50 percent of the time,” he said. “When my research group examined the NHANES database, we found risk-factor modifying therapies and antiplatelet drugs were being prescribed for fewer than 20 percent of PAD patients who did not have previously established coronary or cerebrovascular disease.”

Meanwhile, new antiplatelet drugs have the potential to reduce limb complications of PAD. Technology advances are leading to innovative imaging approaches using optical coherence tomography, intravascular ultrasound, PET computed tomography, contrast-enhanced magnetic resonance imaging and other modalities to image plaques and assess their vulnerability for rupture.

But new treatments only work if they’re used, Creager said.

“We still have a long way to go in awareness, treatment and prevention to preserve vascular health,” he said. “We must continually seek new and creative solutions.”

One way the AHA is doing this is by “building a culture of health,” Creager said. “We believe we can make a difference by helping people make healthy decisions wherever they are — at work, at school, at home and at play.”

The AHA is working toward this goal by advocating for cigarette taxes, clean air laws, access to smoking cessation programs and a ban on marketing electronic cigarettes to children. On the local, state and national levels, the association also advocates for healthier nutrition and increased physical education in schools. In addition, it encourages companies to implement wellness programs that offer health education and supportive environments for employees.


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