Abstract 4371060: A Comparative Analysis of Social Demographic and Clinical Factors for Screening for Peripheral Artery Disease in Adult Patients from Primary Care Clinics

Abstract

Background: Peripheral Artery Disease (PAD) affects over 8.5 million adults in the U.S., contributing to morbidity and mortality. Early detection is critical but often missed, especially in primary care settings, increasing the risk of severe complications, including limb ischemia, ulcers, infections, and amputations. Risk factors include smoking, type 2 diabetes, hypertension, hyperlipidemia, chronic kidney disease (CKD), and arteriosclerosis. We examines PAD prevalence among primary care patients at Sutter Health a large integrated health care system in California, to identify key factors for early screening, referral and treatment. Methods: This retrospective analysis evaluated adults (>18 years; N=81,724) with office, video, or telephone visits in 19 primary care clinics between January 2022 and August 2024. Eligible patients had PAD or related symptoms recorded as their primary reason for visit or noted in their problem lists, or medical history. ICD-10 codes were used to identify comorbidities (hypertension, type 2 diabetes, hyperlipidemia, CKD, COPD, polyneuropathy, arteriosclerosis, smoking history). Social demographics (gender, age, race/ethnicity) were extracted to identify factors associated with PAD. Logistic regression was performed to assess key predictors of PAD diagnosis. Results: Among patients with PAD (N=282), 89% were aged ≥60 years, 52% were male, 51% were White, 24% were Black, and 10% were Hispanic. The most common comorbidities included hypertension (74%), hyperlipidemia (38%), type 2 diabetes (33%), CKD (28%), and arteriosclerosis (18%). Logistic regression showed that patients ≥60 years of age had 29.13 times higher odds (95% CI: 11.68-72.68, p<0.0001). Males had 1.51 times higher odds (95% CI: 1.18-1.93, p=0.0012) than females, while Black patients had significantly higher odds of PAD (OR: 1.484, 95% CI: 1.09–2.02, p=0.0121) compared to Whites. Significant clinical predictors included arteriosclerosis (OR: 3.4, p<0.0001), polyneuropathy (OR: 2.7, p<0.0001), tobacco use (OR: 2.6, p<0.0001), CKD (OR: 2.4, p<0.0001), COPD (OR: 2.4, p<0.0001), and hypertension (OR: 2.4, p<0.0001). Conclusion: Advanced age, males, and Black patients are more likely to have a diagnosis of PAD in primary care populations. The data supports prioritizing PAD screening interventions, particularly in older adults, patients with multiple underlying conditions and Black patient population.