IV 

111TH CONGRESS 

2D SESSION H. RES. 1438 

Promoting increased awareness and diagnosis of peripheral arterial disease 

(PAD) to address the high mortality rate of this treatable disease. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 14, 2010 

Mr. PAULSEN submitted the following resolution; which was referred to the 

Committee on Energy and Commerce 

RESOLUTION 

Promoting increased awareness and diagnosis of peripheral 

arterial disease (PAD) to address the high mortality 

rate of this treatable disease. 

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; 


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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 lowerlimb amputations annually; 

Whereas less than 35 percent of patients with PAD experience typical symptoms and, therefore, many with the disease remain undiagnosed; 


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Whereas screening for PAD is effective, inexpensive, riskfree, 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 Resolved, 

2 SECTION 1. NEED FOR ACTION. 

3 The House of Representatives— 

4 (1) identifies the need for government agencies, 

5 health care organizations, professional societies, 

6 health systems, and clinicians to take actions to im7 prove the diagnosis and treatment of peripheral arte8 rial disease; and 

9 (2) resolves to promote efforts to increase pub10 lic and clinician awareness of PAD. 

11 SEC. 2. ENCOURAGEMENT FOR SPECIFIC ACTIONS. 

12 The House of Representatives encourages the fol13 lowing actions: 

14 (1) The Administrator of the Center for Medi15 care & Medicaid Services should examine ways to inVerDate Mar 15 2010 01:49 Jun 15, 2010 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\HR1438.IH HR1438

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1 crease the number of beneficiaries that are aware of 

2 PAD and screened for the disease. 

3 (2) The Director of the Centers for Disease 

4 Control and Prevention, acting through the National 

5 Heart Disease and Stroke Prevention Program, 

6 should examine ways to educate medical profes7 sionals about the benefits of PAD screening and as8 sess and reduce regional disparities in the diagnosis 

9 and treatment of PAD. 

10 (3) The Director of the National Institutes of 

11 Health should continue the Institutes’ critically im12 portant leadership role in the fight against PAD— 

13 (A) by continuing and increasing the sup14 port of its respective Institutes, including the 

15 National Heart, Lung, and Blood Institute for 

16 basic and clinical PAD research, for PAD com17 parative effectiveness studies, and for assessing 

18 and improving public awareness of PAD; 

19 (B) by encouraging the National Heart, 

20 Lung, and Blood Institute, the National Insti21 tute on Aging, the National Institute of Diabe22 tes and Digestive and Kidney Diseases, the Na23 tional Institute of Nursing Research, and the 

24 National Center on Minority Health and Health 

25 Disparities to provide the necessary funding for 


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1 intramural and extramural biomedical research 

2 and education with respect to PAD through the 

3 co-sponsorship of workshops and seminars with 

4 respected patient organizations; 

5 (C) by exploring collaborative opportunities 

6 for PAD research with national health profes7 sional societies and vascular care foundations 

8 using the multidisciplinary approach of the Na9 tional Institutes of Health; and 

10 (D) by exploring collaborative opportuni11 ties with the Food and Drug Administration 

12 and Centers for Medicare and Medicaid Serv13 ices to expand access to proven diagnostic 

14 methods and therapeutic interventions via spon15 sorship of annual PAD strategic planning meet16 ings. 

17 (4) The Agency of Healthcare Research and 

18 Quality should include PAD in its strategic vision to 

19 improve health outcomes, to strengthen quality 

20 measurement and improvement, and to improve 

21 health care access for individuals with PAD, through 

22 offering support to research centers that specialize 

23 in PAD health care research in the following areas: 

24 (A) Quality improvement and patient safe25 ty. 


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1 (B) Outcomes and effectiveness of care. 

2 (C) Clinical practice and technology assess3 ment. 

4 (D) Health care organization and delivery 

5 systems. 

6 (E) Primary care (including preventive 

7 services). 

8 (F) Health care costs and sources of pay9 ment. 

Æ 


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