Epidemiology of atherosclerotic peripheral arterial occlusive disease in Hong Kong.
The epidemiology of atherosclerotic peripheral arterial disease (PAD) has rarely been studied in Asia. A prospective vascular registry consisting of 510 Chinese patients with PAD from a teaching hospital in Hong Kong disclosed a male/female ratio of 1.6:1.0 with a mean age of 72 years. The predominant pattern was femoropopliteal occlusive disease (49%). Half of all patients had tissue loss on presentation, more so in women (67%) than men (38%). Demographic and biochemical risk factors examined showed many similarities with the West, included smoking (59%), hypertension (55%), diabetes mellitus (42%), hypercholesterolemia (55%), elevated low density lipoprotein (LDL) (60%), triglycerides (31%), hyperfibrinogenemia (62%), and hyperglycemia (49%). Chinese female patients with PAD were older and had a high prevalence of diabetes mellitus (54%). Smoking is less a problem in women (28%). They suffered predominantly from femoropopliteal and distal vessel disease, and two-thirds presented with tissue loss. Female patients also have significantly higher levels of fasting glucose, cholesterol, triglyceride, LDL, and very low density lipoprotein (VLDL). Male patients were mostly smokers (80%) with a higher proportion of aortoiliac disease. Critical ischemia in the form of tissue loss was associated with female sex (p < 0.001), age (p < 0.001), nonsmoking (p < 0.001), diabetes (p < 0.005), a low hemoglobin/hematocrit (p < 0.001), a high white blood cell count (p < 0.001), and high levels of fibrinogen (p < 0.01) and cholesterol (p < 0.05). An increasing incidence of PAD was noted in Hong Kong. Most of the patients present late with advanced ischemia. It is possible that this disease pattern represents only a fraction of the true incidence of PAD in the territory.
Cheng
S W
SW
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.
Ting
A C
AC
Lau
H
H
Wong
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000453:epidemiology*; D002681:China / Q000208:ethnology; D003710:Demography; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005263:Femoral Artery / Q000473:pathology; D005340:Fibrinogen / Q000032:analysis; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006943:Hyperglycemia / Q000453:epidemiology; D006951:Hyperlipoproteinemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007511:Ischemia / Q000453:epidemiology; D008077:Lipoproteins, LDL / Q000097:blood; D008079:Lipoproteins, VLDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D011150:Popliteal Artery / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology
D008077:Lipoproteins, LDL; D008079:Lipoproteins, VLDL; D005340:Fibrinogen