Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2012;65:726-33 - Vol. 65 Num.08 DOI: 10.1016/j.rec.2012.03.007

Prevalence and Clinical Characteristics of Peripheral Arterial Disease in the Study Population Hermex

Francisco J. Félix-Redondo a,, Daniel Fernández-Bergés b, María Grau c, José M. Baena-Diez d, José M. Mostaza e, Joan Vila c

a Centro de Salud Villanueva Norte, Servicio Extremeño de Salud, Villanueva de la Serena, Badajoz, Spain
b Unidad de Investigación Área de Salud, Programa de Enfermedades Cardiovasculares, Servicio Extremeño de Salud y Fundesalud, Villanueva de la Serena, Badajoz, Spain
c Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM, Barcelona, Spain
d Centro de Salud La Marina, Instituto de Investigación en Atención Primaria Jordi Gol, Institut Català de la Salut e IMIM, Barcelona, Spain
e Unidad de Arteriosclerosis, Hospital Carlos III, Madrid, Spain

Keywords

Peripheral arterial disease. Intermittent claudication. Ankle brachial index. Epidemiology. Risk factor. Cardiovascular disease. Alcohol consumption. Physical activity.

Abstract

Introduction and objectives

To estimate the prevalence of peripheral arterial disease as measured on ankle-brachial index and evaluate the associated risk, clinical, and diagnostic factors.

Introduction and objectives

The use of ankle-brachial index for peripheral arterial disease diagnosis is advisable because of the low prevalence of symptomatic cases and the associated change in estimated coronary risk. Screening groups should be adapted to the Spanish population. Smoking and hypercholesterolemia are major associated risk factors.

To estimate the prevalence of peripheral arterial disease as measured on ankle-brachial index and evaluate the associated risk, clinical, and diagnostic factors.

Methods

El uso del índice tobillo-brazo es aconsejable para el diagnóstico de esta enfermedad, dada la baja prevalencia de formas sintomáticas y su capacidad para cambiar el riesgo coronario estimado. Se debería adaptar los grupos de cribado a la población española. Tabaquismo e hipercolesterolemia son los principales factores de riesgo.

La prevalencia de enfermedad arterial periférica fue del 3,7% (intervalo de confianza del 95%, 3,0-4,5%); el 5,0% (3,9-6,3%) en varones y el 2,6% (1,8-3,5%) en mujeres (p=0,001). Las prevalencias acumuladas a partir de 50, 60 y 70 años fueron del 6,2, el 9,1 y el 13,1% respectivamente. La enfermedad era sintomática en el 13,3% (6,8-19,8%) de los casos. Las recomendaciones actuales de cribado no detectaron al 29,6% de los enfermos asintomáticos. El uso del índice aumentó el 32,7% los casos de riesgo coronario alto. Se halló asociación positiva de la enfermedad con edad, tabaquismo, hipercolesterolemia, sedentarismo, microalbuminuria y enfermedad cardiovascular, y negativa con el consumo de alcohol.

Cross-sectional study conducted in a random population-based sample of 2833 individuals aged 25 to 79 years from Don Benito health area (Badajoz). Peripheral arterial disease was considered for ankle-brachial index<0.90. To identify symptomatic disease we used the Edinburgh questionnaire. The current screening recommendations, changes to other categories of estimated coronary risk associated with index measurements, and the association with risk factors were assessed.

Methods

Cross-sectional study conducted in a random population-based sample of 2833 individuals aged 25 to 79 years from Don Benito health area (Badajoz). Peripheral arterial disease was considered for ankle-brachial index<0.90. To identify symptomatic disease we used the Edinburgh questionnaire. The current screening recommendations, changes to other categories of estimated coronary risk associated with index measurements, and the association with risk factors were assessed.

Results

The prevalence of peripheral arterial disease was 3.7% (95% confidence interval, 3.0%-4.5%), 5.0% (3.9%-6.3%) in men and 2.6% (1.8%-3.5%) in women (P=.001). The cumulative prevalence in those aged 50, 60 and 70 years were 6.2%, 9.1%, and 13.1% respectively. The disease was symptomatic in 13.3% (6.8%-19.8%) of cases and 29.6% of asymptomatic patients were not detected as recommended for high-risk groups. The use of ankle-brachial index increased the number of individuals with high coronary risk by 32.7%. Peripheral arterial disease was positively associated with age, smoking, hypercholesterolemia, sedentary lifestyle, microalbuminuria and history of cardiovascular disease, and negatively with alcohol consumption.

Results

The prevalence of peripheral arterial disease was 3.7% (95% confidence interval, 3.0%-4.5%), 5.0% (3.9%-6.3%) in men and 2.6% (1.8%-3.5%) in women (P=.001). The cumulative prevalence in those aged 50, 60 and 70 years were 6.2%, 9.1%, and 13.1% respectively. The disease was symptomatic in 13.3% (6.8%-19.8%) of cases and 29.6% of asymptomatic patients were not detected as recommended for high-risk groups. The use of ankle-brachial index increased the number of individuals with high coronary risk by 32.7%. Peripheral arterial disease was positively associated with age, smoking, hypercholesterolemia, sedentary lifestyle, microalbuminuria and history of cardiovascular disease, and negatively with alcohol consumption.

Conclusions

The use of ankle-brachial index for peripheral arterial disease diagnosis is advisable because of the low prevalence of symptomatic cases and the associated change in estimated coronary risk. Screening groups should be adapted to the Spanish population. Smoking and hypercholesterolemia are major associated risk factors.

1885-5857/© 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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