From the American Heart Association - Experts: Educating the public on vascular disease would increase physician knowledge

  • Alan T Hirsch

Press/Media: Expert Comment or Interview


Experts: Educating the public on vascular disease would increase physician knowledge






Experts at a Boston summit on vascular disease said that educating the public about the risks and symptoms of the disease would then push physicians to become more knowledgeable.

That’s how the medical community quickly came up to speed about the effects of Viagra on erectile dysfunction, pointed out Joshua Beckman, MD, Section of Vascular Medicine director at Vanderbilt University Medical Center.

“Doctors did not run out and learn about phosphodiesterase 5 [inhibitors], but enough patients came in demanding the medication that doctors had to learn,” he said during Thursday’s summit on vascular disease, a broad series of common illnesses affecting arteries and veins.

“Sometimes you don’t want to teach people from above. You want to teach them from below so that physicians are made to learn about something because the demand is created by the patients who walk into the room,” Beckman said. “Educating the public is often more important than educating physicians because doctors will follow the patients.”

The one-day summit this week was convened by the American Heart Association. It gathered leading cardiologists, vascular specialists, clinical scientists and patients. Attendees echoed a common theme: Both the public and the health-care community are vastly ignorant about vascular diseases.

“Members of the public and their physician both have to know a disease exists to be aware of it to establish a prompt, accurate diagnosis,” said Alan T. Hirsch, a vascular medicine specialist and cardiologist at the University of Minnesota Medical School. Yet, currently less than one of four Americans are aware of peripheral artery disease and less than half of Americans are aware of venous thromboembolic diseases, he said.

“We could do much better. In contrast, over 90 percent of Americans are aware of key risk factors, such as hypertension and heart disease. Yet, PAD and VTE are both at least as common, and are equally or more dangerous diseases. Thus, this knowledge gap is deadly. And, none of us are blameless. We simply haven’t done our job. It’s time to begin,” he said.

Most doctors get little training about vascular diseases, especially compared to other topics they are taught in school, said AHA President Mark Creager, a cardiovascular disease specialist and director of the Heart and Vascular Center at the Dartmouth-Hitchcock Medical Center. That results in a limited understanding of how to diagnose vascular diseases, their implications and how they should be treated.

Several vascular disease patients who spoke at the summit recounted stories of how their primary care physicians failed to recognize basic symptoms and signs, often leading to tragic results.

Amy Fordham-Duff described her ordeal of being treated for a pulmonary embolism following the deep vein thrombosis that developed after she was treated for an unrelated orthopedic procedure.

Fordham-Duff said she continues to suffer emotional trauma four years later and still finds herself wondering: “Was everything done that could have been done to have prevented this from happening to me and my family?”

Larry Sadwin, a former AHA board chairman, described the great contrast between how his doctors treated him for coronary artery disease – which he has lived with for three decades – and peripheral artery disease, which doctors failed to recognize despite basic signs, like the ache in his right calf when walking.

“I love my PCP but I’m still trying to understand how we missed this for a period of time” said Sadwin, now board chairman of Bradley Hospital in Rhode Island.

“Unlike my heart disease, I did not find the information or the support to deal with a disease state that I felt could affect the quality of my life in any number of levels – no support groups, no rehab, no critical information, no coverage.”

The AHA summit focused its scope to peripheral artery disease, aortic and peripheral aneurysms, and venous disease, primarily venous thromboembolism.

Peripheral artery disease is now recognized as one of the most common and dangerous of all cardiovascular diseases. It affects 8 million people in the country, with risk factors that include smoking, high blood pressure and high cholesterol. Venous thromboembolism affects about 900,000 people, and it kills 60,000-100,000 people in the United States each year.

But even people who have first-hand experience of vascular disease fail to understand the basics of the disorder, said Mary Cushman, director of the Thrombosis and Hemostasis Program at the University of Vermont Medical Center.

Cushman said she often quizzes patients at the tail end of their treatment at her center to discuss long-term prevention strategies.

“I would say the majority cannot recite back the signs and symptoms they’re supposed to be looking for, for recurrence, and this is in a clinic devoted to this issue,” she said. “So the awareness is not just the people who have never had it, but it’s in the patients themselves.”

Summit participants adamantly asked for the AHA to play a bigger role in both bringing its brand to the problem, as well as becoming an advocate for prevention and education.

“Without the American Heart Association, there is now almost no vascular disease advocacy,” said Hirsch, and he pointed out the loss of smaller non-profit organizations such as the Vascular Disease Foundation and the PAD Coalition.

“There are no other national health organizations that could so effectively bring together the public, health professionals, industry and government stakeholders. This is what the American Heart Association does so well. We clearly have a well-defined public health mandate, and many people who care. Yet, in a world in which most health efforts are underfunded and disparate missions can sometimes divert our effort, it is now mission critical for AHA to provide the leadership mandated by these incredible public health needs.”

PeriodNov 15 2015

Media coverage


Media coverage


  • vascular diseases
  • peripheral artery disease
  • public health
  • health literacy
  • community health