Peripheral Artery Disease and African Americans: Review of the Literature
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RACE AND ETHNICITY DISPARITIES (M. ALBERT, SECTION EDITOR)
Peripheral Artery Disease and African Americans: Review of the Literature Khendi White Solaru 1 Published online: 25 July 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose of Review Peripheral artery disease (PAD) is a chronic, obstructive disease of the peripheral vasculature which is a coronary heart disease risk equivalent. African Americans (AA) are at the highest risk for developing this disease at every age group. The purpose of this review is to shed light on the risk factors for PAD and their implications for disease manifestation in AA, and to highlight ways to combat these known racial disparities in order to achieve cardiovascular health equity in this population. Recent Findings Even after controlling for differences in the prevalence of known cardiovascular risk factors, AA are still significantly more likely to have PAD. In part, due to a disproportionate amount of cardiovascular risk factors and detrimental socioeconomic factors, AA with PAD have a worse prognosis and more unfavorable outcomes than other ethnic groups with PAD. AA with PAD are more likely to have limb loss with amputation and less likely to receive revascularization leading to limb salvage. Summary Advanced age, cigarette smoking, diabetes, hypertension, hyperlipidemia, chronic kidney disease, and poor socioeconomic status or education level have all been associated with increased risk of PAD. AA have a higher likelihood of having many, but not all, of these conditions. Nevertheless, increased cardiovascular risk for PAD combined with a relative lack of awareness about the disease in the AA community leads to poor health outcomes. Targeted interventions that partner healthcare access and delivery in community-based, non-traditional health care settings as well as the traditional clinics and hospitals may prove to be a more successful means of outreach in this high-risk population. Keywords African Americans . Peripheral artery disease . Racial disparities . Ethnic differences . Cardiovascular risk
Background Peripheral artery disease (PAD) is a chronic, debilitating condition stemming from atherosclerotic, obstructive disease in the arteries of the peripheral vasculature, most notably of the lower extremities. It is a common cause of morbidity, mortality, and disability due to limb loss [1, 2]. It is also a marker of underlying atherosclerotic This article is part of the Topical Collection on Race and Ethnicity Disparities * Khendi White Solaru [email protected] 1
Sections of Vascular Medicine and Cardiology, Department of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, 11100 Euclid Avenue, Mailstop LKS 5038, Cleveland, OH 44106, USA
disease in other vascular beds reflecting an increased risk of ischemic stroke, myocardial infarction, and death due to cardiovascular disease [3–8]. As a result, PAD has been recognized as a coronary heart disease risk equivalent by major cardio
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