title: Determinants of peripheral arterial disease in the elderly: the Rotterdam study.
abstract: OBJECTIVE
  To examine which atherosclerotic risk factors are determinants for peripheral arterial disease (PAD), we performed a population-based study in 6450 subjects (40% men, 60% women) aged 55 years and older.
  
  
  METHODS
  The presence of PAD was assessed by measuring the ankle-arm systolic blood pressure index (AAI); PAD was considered present if the AAI was lower than 0.90 in either leg. In addition, a threshold AAI of 0.70 in either leg defined severe PAD.
  
  
  RESULTS
  Determinants strongly and independently associated with PAD were age of at least 75 years (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.0-1.6), fibrinogen level (OR, 1.5; 95% CI, 1.3-1.7), cigarette smoking (OR, 2.8; 95% CI, 2.3-3.4), diabetes mellitus (OR, 2.0; 95% CI, 1.6-2.5), and systolic blood pressure (OR, 1.2; 95% CI, 1.1-1.2). An inverse relation of high-density lipoprotein cholesterol level with PAD (OR, 0.7; 95% CI, 0.5-0.8) was found. Similar results were demonstrated for severe PAD. Separate analyses for men and women did not demonstrate differences in risk factors for PAD.
  
  
  CONCLUSIONS
  Assessment of a wide range of atherosclerotic risk factors enabled us to quantify the relative importance of each factor as determinant for PAD. In total, 69% of the occurrence of PAD is attributable to cardiovascular risk factors measured in our study; smoking accounted for most (etiologic fraction, 18.1%). The results suggest that preventive management of PAD should be directed at systolic blood pressure, fibrinogen level, smoking, high-density lipoprotein cholesterol level, and diabetes mellitus. Arch Intern Med. 2000;160:2934-2938
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus University Medical Center Rotterdam, the Netherlands.
authors.forename: W T
authors.initials: WT
authors.lastname: Meijer
authors.forename: D E
authors.initials: DE
authors.lastname: Grobbee
authors.forename: M G
authors.initials: MG
authors.lastname: Hunink
authors.forename: A
authors.initials: A
authors.lastname: Hofman
authors.forename: A W
authors.initials: AW
authors.lastname: Hoes
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D012307:Risk Factors