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The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program

Department of Medicine, University of Colorado School of Medicine, Denver, CO, USA

William R Hiatt

Department of Medicine, University of Colorado School of Medicine, Denver, CO, USA; The Colorado Prevention Center, Denver, CO, USA

Joseph R Coll

The Colorado Prevention Center, Denver, CO, USA; Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver, CO, USA

Michael H Criqui

Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, San Diego, CA, USA

Diane Treat-Jacobson

University of Minnesota School of Nursing, Minneapolis, MN, USA

Mary M McDermott

Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Alan T Hirsch

Division of Epidemiology and Community Health, University of Minnesota School of Public Health and Vascular Medicine Program, Minneapolis Heart Institute Foundation, Minneapolis, MN, USA

Abstract

This study tested the hypothesis that patients with PAD have impaired health-related quality of life (HRQoL) to a degree similar to that of patients with other types of cardiovascular disease (other-CVD), and also evaluated the clinical features of PAD associated with impaired HRQoL. This was a cross-sectional study in 350 primary care practice sites nationwide with 6,499 participants. The reference group had no clinical or hemodynamic evidence of PAD or other-CVD; the PAD group had an ankle-brachial index < 0.90 or a prior history of PAD; the other-CVD group had a clinical history of cardiac or cerebral vascular disease (but no PAD), and the combined PAD-other-CVD group included both diagnoses. Individuals were assessed using four HRQoL questionnaires including the Walking Impairment Questionnaire (WIQ), Medical Outcomes Study SF-36 (SF-36), Cantril Ladder of Life and the PAD Quality of Life questionnaire. PAD patients had lower WIQ distance scores than the other-CVD group. Both the PAD and other-CVD groups had significantly lower SF-36 Physical Function scores compared with the reference group. The WIQ revealed that PAD patients were more limited by calf pain, whereas other-CVD patients were more limited by chest pain, shortness of breath and palpitations. In conclusion, in this nationwide study, one of the first to directly compare the HRQoL burden of CVD with that of PAD, the evaluation of PAD in office practice revealed a HRQoL burden as great in magnitude as in patients with other forms of CVD.

Key Words: cardiovascular disease • claudication • functional status • health-related quality of life • peripheral arterial disease

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