APMA News - September/October 2024 - 16

Updated PAD Guidelines:
Key Insights for Podiatrists
Research consistently demonstrates that
the best long-term outcomes for PAD patients
are achieved with a multidisciplinary approach,
which notably includes podiatry. In 2020, this
approach gained formal recognition when the
American Heart Association and the American
College of Cardiology invited APMA to join their
Guidelines Writing Committee for updating the
2016 AHA-ACC PAD Guidelines. The updated
PAD Guidelines are the first to recognize
podiatry as a key player in the diagnosis and
management of PAD. APMA News had a conversation
with John Evans, DPM, chief of Podiatry
at Beaumont Hospital and Medical Center in
Dearborn, MI, who represented podiatry on the
committee, and discussed the significance of the
newly published guidelines on PAD prevention
and treatment.
The guidelines highlight the use of new diagnostic
tools and the importance of ongoing patient
education and monitoring post-intervention.
" Because we as podiatrists examine the feet
and legs in almost every visit with a patient, " Dr.
Evans said, " we are the prime specialty that would
be able to see the manifestations of PAD development
in the lower extremity-greater than any
other specialty. "
The updated guidelines involve multidisciplinary
collaboration and have introduced new treatment
options. " For the first time, they reached out to
APMA, asking for a member to be on the writing
committee. They recognized podiatry as being
important to the treatment of PAD. We are officially
recognized by the medical community as one of
the primary legs of the table that treat PAD, " Dr.
Evans said.
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apmanews
SEPTEMBER/OCTOBER 2024
Many PAD patients are asymptomatic or experience
atypical symptoms. Dr. Evans said, " Twothirds
of the patients that have [PAD] are asymptomatic,
or their symptoms are atypical. It often
can be ascribed to just getting older or arthritis. We
need to be acutely aware of these situations. "
Podiatrists should be vigilant for red flags such
as a history of heart disease, previous strokes, or
diabetes. " By looking at the medical history-if a patient
has had a previous MI or stroke, there's a high
risk that the legs are also going to be involved, " said
Dr. Evans.
The guidelines promote teamwork between
podiatrists, vascular surgeons, and other specialists.
Dr. Evans reflected on this collaboration. " We
brought together over 20 vascular specialists,
physicians, and nurses who were in the specialty to
write these guidelines. It's truly an interdisciplinary
publication. "
Educating patients about PAD and its risks is
crucial. " Peripheral arterial disease has extremely
bad PR. People who know it's a risk don't think it's
going to happen to them. "
Podiatrists should advocate for risk modification
strategies such as smoking cessation and exercise.
Dr. Evans added, " The earlier we can become
aware that a patient is on the path to PAD, the
earlier interventions can occur. Smoking cessation,
blood pressure management, and exercise are key. "
Dr. Evans hopes to see more clinical advancements
in PAD treatment, particularly interventions
that can slow disease progression or offer new
treatment options for patients who currently lack
them. Research on non-invasive techniques and
patient education strategies could also enhance
care outcomes.
https://www.ahajournals.org/doi/epdf/10.1161/CIR.0000000000001251 https://www.ahajournals.org/doi/epdf/10.1161/CIR.0000000000001251
APMA News - September/October 2024

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