Clinical Geriatrics

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. Valid June 1 - August 31, 2005. Estimated time: 1 hour

FULL DISCLOSURE POLICY AFFECTING CME ACTIVITIES
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or provider has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following: Dr. Gunderson and Dr. Federman have indicated that they have not received financial support for consultation, research or evaluation or have a financial interest relevant to this article. No faculty member has indicated that their presentation will include information on off-label products.

DISCLAIMER STATEMENT
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Educational Objectives
1. To understand the epidemiology and risk factors for the development of peripheral arterial disease
2. To recognize the clinical signs and symptoms of peripheral arterial disease
3. To be able to treat the symptoms of peripheral arterial disease
4. To be able to prevent the cardiovascular morbidity and mortality associated with peripheral arterial disease

The term peripheral arterial disease (PAD) refers to atherosclerotic disease of the lower extremities and is important for several reasons. First, its presence has been found to be an independent risk factor for vascular disease in other
regions, resulting in increased rates of cardiovascular events and mortality. Second, PAD can itself be symptomatic, causing claudication and potentially limb-threatening ischemia. Last, there is a growing appreciation of the more subtle ways PAD may be manifested symptomatically, either by atypical leg pain or by adversely affecting functional status. Peripheral arterial disease is important for the older adult for all of these reasons, especially because its prevalence increases markedly with age.

EPIDEMIOLOGY
Peripheral arterial is common. A recent population-based survey in the United States found the overall prevalence of PAD to be 4.3% in participants over 40 years of age and 14.5% in those over age 70 years.1 Indeed, age is a major risk factor for PAD.