Whereas atherosclerosis occurs when blood flow is reduced
because arteries become narrowed or blocked with fatty deposits;
Whereas atherosclerosis is responsible for more deaths in
the United States than any other condition and heart attacks, resulting from
clogged chest arteries, are the leading cause of death in America;
Whereas atherosclerosis also affects arteries of the brain
and leads to strokes, which are the third most common cause of death in the
United States, killing nearly 150,000 people annually;
Whereas atherosclerosis also occurs in the legs and is
known as peripheral arterial disease (in this resolution referred to as
PAD
) and having PAD significantly increases the risk for heart
attack, stroke, amputation, and death;
Whereas most Americans are aware of atherosclerosis in the
brain and heart, 3 out of 4 Americans have never heard of PAD and Americans
with PAD are often unaware of the serious risks of the condition;
Whereas despite low levels of awareness, PAD is common and
deadly with eight to twelve million Americans having PAD and these individuals
suffer a 5-year mortality rate that is higher than that faced by individuals
with stroke, heart disease, or breast cancer;
Whereas the incidence of PAD is likely to increase in the
United States with the rise of both obesity and diabetes;
Whereas of those Americans with severe PAD, also known as
critical limb ischemia, 35 percent may suffer an amputation and 20 percent may
die within 6 months;
Whereas PAD is the primary cause of amputations in the
United States, with more than 100,000 amputations occurring annually, at a cost
of more than $3 billion;
Whereas PAD disproportionately affects certain populations
including Americans aged 65 and older, African-Americans, and adults with
diabetes;
Whereas PAD is a major risk factor for amputations in
people with diabetes, contributing to about 71,000 lower-limb amputations
annually;
Whereas less than 35 percent of patients with PAD
experience typical symptoms and, therefore, many with the disease remain
undiagnosed;
Whereas screening for PAD is effective, inexpensive,
risk-free, and accurate and can be part of routine medical care;
Whereas Medicare and many private health plans do not
cover a one-time screening to detect PAD;
Whereas once PAD is detected, heart attacks, strokes,
amputations, and deaths can be reduced through the use of national,
evidence-based PAD care guidelines; and
Whereas there is a need for national efforts to ensure
that patients at highest risk for undiagnosed PAD have access to diagnostic
tests and patients diagnosed with the disease are being treated according to
evidence-based guidelines to improve patient outcomes: Now, therefore, be
it
1.The House of Representatives—
(1)identifies the need for government
agencies, health care organizations, professional societies, health systems,
and clinicians to take actions to improve the diagnosis and treatment of
peripheral arterial disease; and
(2)resolves to
promote efforts to increase public and clinician awareness of PAD.
2.Encouragement for
specific actionsThe House of
Representatives encourages the following actions:
(1)The Administrator of the Center for
Medicare & Medicaid Services should examine ways to increase the number of
beneficiaries that are aware of PAD and screened for the disease.
(2)The Director of the Centers for Disease
Control and Prevention, acting through the National Heart Disease and Stroke
Prevention Program, should examine ways to educate medical professionals about
the benefits of PAD screening and assess and reduce regional disparities in the
diagnosis and treatment of PAD.
(3)The Director of the National Institutes of
Health should continue the Institutes’ critically important leadership role in
the fight against PAD—
(A)by continuing and
increasing the support of its respective Institutes, including the National
Heart, Lung, and Blood Institute for basic and clinical PAD research, for PAD
comparative effectiveness studies, and for assessing and improving public
awareness of PAD;
(B)by encouraging the National Heart, Lung,
and Blood Institute, the National Institute on Aging, the National Institute of
Diabetes and Digestive and Kidney Diseases, the National Institute of Nursing
Research, and the National Center on Minority Health and Health Disparities to
provide the necessary funding for intramural and extramural biomedical research
and education with respect to PAD through the co-sponsorship of workshops and
seminars with respected patient organizations;
(C)by exploring
collaborative opportunities for PAD research with national health professional
societies and vascular care foundations using the multidisciplinary approach of
the National Institutes of Health; and
(D)by exploring
collaborative opportunities with the Food and Drug Administration and Centers
for Medicare and Medicaid Services to expand access to proven diagnostic
methods and therapeutic interventions via sponsorship of annual PAD strategic
planning meetings.
(4)The Agency of Healthcare Research and
Quality should include PAD in its strategic vision to improve health outcomes,
to strengthen quality measurement and improvement, and to improve health care
access for individuals with PAD, through offering support to research centers
that specialize in PAD health care research in the following areas:
(A)Quality
improvement and patient safety.
(B)Outcomes and
effectiveness of care.
(C)Clinical practice
and technology assessment.
(D)Health care
organization and delivery systems.
(E)Primary care
(including preventive services).
(F)Health care costs
and sources of payment.