[The association between a cerebrovascular accident and peripheral arterial disease: a case-control study in Asturias, Spain].
OBJECTIVE
To evaluate peripheral arterial disease (PAD) and total stroke, cortical infarction, deep infarction and cerebral hemorrhage.


BACKGROUND
The different manifestations of atherosclerotic disease, despite being considered a systemic disease, have different risk factors and complex associations between themselves. On the other hand, the relationship between stroke and PAD is poorly understood.


METHODS
Case-control and population based study of incidence. Place and time: Asturias, Spain, 1990-1992. Dependent variable: stroke, defined according to WHO criteria.


METHODS
PAD, defined according to clinical symptoms of intermittent claudication. Confounding potentials: age, sex, alcohol, smoking, arterial hypertension, hyperglycemia, heart disease. Analysis methods: bivariant comparisons and multivariant analysis by the logistic regression model.


METHODS
458 cases and 470 controls.


RESULTS
PAD was associated with total stroke (OR: 3.4; 95% CI 1.7-7.3), cerebral infarction (OR: 3.2; 95% CI 1.5-6.8), cortical infarction (OR: 3.1; 95% CI 1.3-7.7) and intracerebral hemorrhage (5.0 95% CI 2.0-12.3) once adjusted for risk factors of these diseases. No association was found between small deep infarction and PAD.


CONCLUSIONS
The association between stroke and PAD possibly denotes similar substrates for both entities. The association of superficial infarction and PAD is postulated to be due to atherosclerotic involvement of large and medium sized arteries, while the association between PAD and cerebral hemorrhage is due to atherosclerotic involvement of small arteries.
Caicoya Gómez-Morán
M
M
Servicio de Epidemiología Clínica y Medicina Preventiva, Area IV, Hospital Monte Naranco, Oviedo.
Corrales Canel
C
C
Lasheras Mayo
C
C
Cuello Rocas
R
R
Rodríguez Alvarez
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007383:Intermittent Claudication / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires