Modifiable

in Atherosclerosis and Risk Factors

Applied

Type

Modification

Confidence

92%

Created

Apr 26, 2026

Evidence

1 source

Rationale

The existing citation acc 2025 for the diabetes mellitus bullet point has been replaced with the superseding ACC/AHA guideline ACC/AHA (PMID 41252847), which covers the same recommendation regarding comprehensive risk factor modification and multidisciplinary care for DM in the context of PAD/CLTI. No other content changes are warranted as the remaining claims are unaffected by the provided article.

Evidence

ACC/AHA. Management of Lower Extremity Peripheral Artery Disease: Guidelines From the ACC/AHA. 2026. PMID: 41252847.
Verified source
PubMedDOI

Content Changes

* **Smoking:** most important risk factor; increases peripheral artery disease (PAD) risk 2–4 fold. Smoking cessation improves survival and limb salvage [@willigendael2004].
* **Diabetes mellitus (DM):** accelerates medial calcification, distal disease, and restenosis risk. It is a major risk factor for chronic limb-threatening ischemia (CLTI), requiring comprehensive risk factor modification and multidisciplinary care [@acc2025].[@acc2026-d].
* **Hypertension:** contributes to endothelial dysfunction, shear stress, and plaque rupture.
* **Dyslipidemia:** elevated low-density lipoprotein (LDL) and reduced high-density lipoprotein (HDL) promote plaque formation.
* **Chronic kidney disease (CKD):** accelerates atherosclerosis and is associated with a higher risk of vascular calcification.
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