Profile of Atherosclerotic Risk Factors and Management in Patients of Peripheral Arterial Disease at a Tertiary Care Teaching Hospital of North India

Peripheral arterial disease, being a manifestation of systemic atherosclerosis, carries a high risk of adverse cardiovascular events. Secondary medical prevention therapies of same magnitude as that for coronary artery disease are recommended for peripheral arterial disease patients also. Available evidence indicates that this condition commonly remains underdiagnosed and undertreated. There is lack of any report about management of these patients in India. The objectives of the present study were to characterize the atherosclerotic risk factor profile and pattern of drug prescription for patients of peripheral arterial disease at a tertiary care teaching hospital and to compare this management with standard guidelines. Data were collected from prescriptions of patients attending cardiothoracic and vascular surgery outpatient department with diagnosis of atherosclerotic peripheral arterial disease from July 2012 to Jun 2013. One hundred twenty prescriptions were analysed. The mean age (±SD) of patients was 53±7.18 years and 23.3% were females. History of smoking, either past or present, was present in 91.6% patients. History of ischemic heart disease was present in 25%, while 26.7% patients were diabetic. Mean number of cardiovascular risk factors was 2.6. The percentage of eligible patients who were receiving a particular drug was 100% for aspirin and statins, 48.3% for angiotensin converting enzyme inhibitors, 46.7% for beta blockers and 66.7% for cilostazol. The vascular surgeons of this centre are using antiplatelet agents and statins adequately for peripheral arterial disease. The prescription of angiotensin converting enzyme inhibitors, beta blockers and cilostazol is low. Exercise therapy and smoking cessation need more attention.