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 at-
tacks, resulting from clogged chest arteries, are the lead-
ing 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 peo-
ple 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 amputa-
tion 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 oc-
curring annually, at a cost of more than $3 billion; 
Whereas PAD disproportionately affects certain populations 
including Americans aged 65 and older, African-Ameri-
cans, and adults with diabetes; 
Whereas PAD is a major risk factor for amputations in peo-
ple with diabetes, contributing to about 71,000 lower- 
limb amputations annually; 
Whereas less than 35 percent of patients with PAD experi-
ence typical symptoms and, therefore, many with the dis-
ease remain undiagnosed; 
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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, ampu-
tations, 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 dis-
ease are being treated according to evidence-based guide-
lines to improve patient outcomes: Now, therefore, be it 
Resolved, 
SECTION 1. NEED FOR ACTION. 
The House of Representatives— 
(1) identifies the need for government agencies, 
health care organizations, professional societies, 
health systems, and clinicians to take actions to im-
prove the diagnosis and treatment of peripheral arte-
rial disease; and 
(2) resolves to promote efforts to increase pub-
lic and clinician awareness of PAD. 
SEC. 2. ENCOURAGEMENT FOR SPECIFIC ACTIONS. 
The House of Representatives encourages the fol-
lowing actions: 
(1) The Administrator of the Center for Medi-
care & Medicaid Services should examine ways to in-
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crease 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 profes-
sionals about the benefits of PAD screening and as-
sess 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 im-
portant leadership role in the fight against PAD— 
(A) by continuing and increasing the sup-
port of its respective Institutes, including the 
National Heart, Lung, and Blood Institute for 
basic and clinical PAD research, for PAD com-
parative effectiveness studies, and for assessing 
and improving public awareness of PAD; 
(B) by encouraging the National Heart, 
Lung, and Blood Institute, the National Insti-
tute on Aging, the National Institute of Diabe-
tes and Digestive and Kidney Diseases, the Na-
tional Institute of Nursing Research, and the 
National Center on Minority Health and Health 
Disparities to provide the necessary funding for 
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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 profes-
sional societies and vascular care foundations 
using the multidisciplinary approach of the Na-
tional Institutes of Health; and 
(D) by exploring collaborative opportuni-
ties with the Food and Drug Administration 
and Centers for Medicare and Medicaid Serv-
ices to expand access to proven diagnostic 
methods and therapeutic interventions via spon-
sorship of annual PAD strategic planning meet-
ings. 
(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 safe-
ty. 
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(B) Outcomes and effectiveness of care. 
(C) Clinical practice and technology assess-
ment. 
(D) Health care organization and delivery 
systems. 
(E) Primary care (including preventive 
services). 
(F) Health care costs and sources of pay-
ment. 
Æ 
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