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Diffuse Atherosclerotic Vascular Disease

Atherosclerosis affects all vascular beds, and underlying risk factors were identified above. Endothelial dysfunction in nonobstructive CAD is associated with an increased risk for cardiovascular events.[205] Atherosclerotic diseases include CAD, PVD, cerebrovascular disease, renal artery stenosis, and abdominal aortic aneurysm. In patients hospitalized with CAD, 40% have PVD on testing the ankle–brachial index.[56] With more advanced CAD, the greater the likelihood of PVD.[13] In patients admitted for vascular surgery, CAD is noted in 46%, carotid stenosis in 32%, and renal artery stenosis in 5%.[229] In patients with abdominal aortic aneurysm, 71% have CAD, 46% have PVD, and 27% have cerebrovascular disease.[202]

CR programs must take into account the diffuse nature of atherosclerosis. In addition, cardiac precautions should be stipulated during the rehabilitation of patients with thrombotic strokes, PVD, and dysvascular amputation (see Chapters 12, 13, …