M. Vray et al., NATIONAL STUDY OF OBLITERATIVE ARTERIAL-DISEASE OF THE LOWER-LIMBS INVOLVING GENERAL-PRACTITIONERS IN FRANCE - ARTEMIO STUDY, Journal of cardiovascular pharmacology, 25, 1995, pp. 51-57
A national survey was performed in France from May to June, 1993. The
aim of this study was to evaluate general practitioners' attitudes and
behaviors when diagnosing and managing patients with lower extremity
arterial disease (LEAD). One thousand general practitioners, randomly
drawn from an exhaustive list, were contacted to participate in a tele
phone interview concerning the last patient with intermittent claudica
tion seen in their practice. Four hundred seventy-six general practiti
oners participated. Risk factors noted for these 476 patients with int
ermittent claudication were in agreement with the literature: 86% were
men aged 64 +/- 10 years (mean +/- SD) and 14% were women aged 73 +/-
8 years. Sixty-two percent had a pain-free walking distance of betwee
n 100 and 500 meters at diagnosis. Forty-five percent were former smok
ers and 37% currently smoked; 55% had hypertension, 14% diabetes, and
56% disturbances of lipid metabolism. A majority of them were hypercho
lesterolemic. The diagnosis of the disease was based primarily on a cl
inical assessment, confirmed for 33% by Doppler or echo Doppler. The m
ean duration of diagnosis was 4.4 +/- 4.1 years. Management of the dis
ease was mainly by prescription of vasodilators (91%), antiplatelet ag
ents (59%), and anticoagulants (8%), Use of Doppler or echo Doppler wa
s recommended once a year. Infection was observed in 27% of patients.
Thirty-eight percent had had a cardiac incident (angina pectoris or my
ocardial infarction) and 10% a cerebrovascular accident. They differed
significantly from those with LEAD alone for the following parameters
: age (68.5 +/- 9.2 vs, 63.2 +/- 10.3 years; p < 0.001); duration of L
EAD (5.6 +/- 4.6 vs, 3.6 +/- 3.5 years; p < 0.001); hypertension (65%
vs, 50%; p < 0.01); and current smoking (29% vs. 43%; p < 0.01). This
survey confirmed the feasibility of telephone interviewing, on a large
sample of general practitioners in France. The high level of associat
ion with other cardiac incidents was, for these patients, a much highe
r risk of mortality and morbidity than LEAD alone. It would be interes
ting to validate the associations observed with a prospective study of
comorbidity.