Nov 30, 2016
Data show Native Americans twice as likely to receive amputation than Caucasian counterparts
WASHINGTON – The CardioVascular Coalition (CVC), a leading group of community-based cardiovascular and endovascular care providers, physicians, and manufacturers created to advance community-based solutions designed to improve awareness, prevention, and intervention of vascular disease, is calling attention to the racial disparities in amputation rates among Native Americans with Peripheral Artery Disease (PAD). In recognition of Native American Heritage Month this November, vascular care leaders are urging at-risk populations to know their risks for PAD and treatment options to manage the disease and avoid related amputation.
PAD is a life-threatening circulatory condition, which causes narrowing or blockage of the vessels that carry blood from the heart to the legs and affects as many as 18 million Americans, and disproportionately impacts Native American communities. According to the First Nations Limb Preservation Foundation, data show that Native Americans experience both diabetes and PAD at a rate two times higher than other populations. Diabetes is a common risk factor for PAD.
A recent analysis, “Racial Disparities in Amputation Rates among Native Americans with Peripheral Artery Disease,” concludes that in specific regions of the country, Native Americans with PAD are substantially more likely to undergo a PAD-related amputation than are Caucasians. The analysis concludes that variations in amputation rates appear to reflect differences in treatment patterns that are unrelated to illness severity, demographic factors or hospital characteristics, suggesting that disparities may reflect systematic differences in treatment patterns by race.
The analysis also compared the rates of PAD risk factors among Caucasians and Native Americans and found that in several leading risk factors – diabetes, chronic hypertension and chronic renal insufficiency (kidney disease) – the Native American sample had significantly higher rates of diagnoses. Other risk factors – including smoking, high cholesterol and history of stroke – were common in the Caucasian sample.
If not properly managed, both diabetes and PAD can lead to non-traumatic lower limb amputations, which data show lead to lower quality of life, increased risk for death and higher healthcare costs.
“Our analysis underscores the critical need to address PAD and amputation rates among Native American communities. Our data show that there is no clinical reason why amputation rates should be disproportionately higher among Native Americans. This mirrors other data illustrating a need for increased understanding and access to appropriate interventional treatment for at-risk Native Americans,” said Harry Kotlarz, co-author of the analysis and Director of Healthcare Policy Cardiovascular Systems, Inc. “Native American Heritage Month reminds us that we must educate this vulnerable population to ensure limb preservation efforts are put in place and amputation rates decline.”