The unsung perils of peripheral arterial disease: a malady in search of a patient.

Peripheral arterial disease (PAD) is increasingly recognized as a strong predictor of mortality and morbidity from atherosclerotic events, especially from coronary heart disease. Since vascular disease remains the most common cause of death in the world, the substantial prevalence, ease of diagnosis, and ominous prognosis have increased interest in PAD among the prevention community. The association with coronary heart disease is strong enough that for prevention purposes, PAD should be considered a high-risk condition that demands aggressive therapy to reduce incident vascular events. Unlike other forms of atherosclerotic disease, PAD is easily diagnosed in the outpatient clinic noninvasively, using the ankle brachial index. Because its diagnosis can thus be seamlessly integrated into the routine clinical encounter, the ankle brachial index has emerged as a tool for global risk assessment. This article will review the relationship between PAD and other vascular disease, emphasizing the role of PAD in prevention efforts.