Reducing cardiovascular mortality in vascular surgical patients with PAD

Supervisors:

• Professor Rob Sayers rs152@leicester.ac.uk
• Dr Sharmin Shabnam

Project description:

Background

The 10-year NHS plan for cardiovascular disease involves reducing mortality by 25% over the next decade. This project will investigate causes of mortality in vascular patients with peripheral arterial disease (PAD). It will assess the NHS plan to reduce death rates and examines the contribution that vascular services could make by earlier diagnosis and novel interventions for PAD. The project will investigate innovative technologies to diagnose PAD in both primary and secondary care and the role that increasing NHS Health Checks could make on identifying an asymptomatic cohort with PAD who are at high risk.

The project will develop models for the impact on prognosis of identification of, and improvement in, cardiovascular risk factors in patients with CVD. Risk factor modification will be assessed including the role of novel pharmacological interventions alongside supervised exercise therapy.

Programme of research

Phase 1: Epidemiology, Data Validity and Mortality in PAD

This phase will examine the epidemiology, recording, and mortality burden of peripheral arterial disease (PAD) using routinely collected electronic health record data. Key research questions include:

• How accurately is PAD captured within NHS electronic health records, and how have incidence, prevalence, and recording patterns changed over time?
• What are the contemporary mortality rates and major causes of death among PAD patients, and what contribution does PAD make to overall cardiovascular mortality?
• To what extent are current mortality outcomes consistent with historical estimates, and what scope exists for reducing cardiovascular mortality in PAD populations?

Phase 2: Risk Factor Management and Care Pathways in PAD

This phase will evaluate current approaches to cardiovascular risk reduction and secondary prevention in PAD patients. Key research questions include:

• To what extent are PAD patients receiving optimal evidence-based management, including medication optimisation, lifestyle modification, smoking cessation, and exercise interventions?
• What is the current evidence base and real-world role of supervised exercise programmes and metabolic or integrated cardiovascular risk clinics in PAD management?

Phase 3: Modelling the Potential Impact of Optimised PAD Care

This phase will model the potential impact of improved PAD management strategies on cardiovascular outcomes and mortality. Key research questions include:

• What reductions in cardiovascular morbidity and mortality might be achievable through optimisation of risk factor management and preventative care pathways in PAD populations?
• Which interventions or service models are likely to have the greatest impact on long-term outcomes in PAD patients?

References:

https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2025/july/what-the-nhs-10-year-health-plan-means-for-cardiovascular-care

https://www.nice.org.uk/guidance/cg147

Please refer to the entry requirements, funding and application advice below before submitting your application