Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: a longitudinal study.
The current study describes the age- and sex-specific incidence rates and risk factors for asymptomatic and symptomatic peripheral arterial occlusive disease (PAOD) among 2,327 subjects and the incidence of intermittent claudication in asymptomatic PAOD subjects. The study population was selected from 18 general practice centers in the Netherlands. PAOD was assessed with the ankle-brachial blood pressure index, and intermittent claudication was assessed with a modified version of the Rose questionnaire. After 7.2 years, the overall incidence rate for asymptomatic PAOD, using the person-years method, was 9.9 (95% confidence interval (CI): 7.3, 18.8) per 1,000 person-years at risk. The rate was 7.8 (95% CI: 4.9, 20.3) for men and 12.4 (95% CI: 7.7, 24.8) for women. For symptomatic PAOD, the incidence rate was 1.0 (95% CI: 0.7, 7.5) overall, 0.4 (95% CI: 0.3, 10.0) for men, and 1.8 (95% CI: 1.0, 10.3) for women. Multivariate analyses showed that increasing age, smoking, hypertension, and diabetes mellitus were the most important risk factors. The overall incidence rate for intermittent claudication among PAOD subjects who were asymptomatic at baseline was 90.5 per 1,000 person-years at risk (95% CI: 36.4, 378.3). The incidence of asymptomatic PAOD was higher than the incidence of symptomatic PAOD, with women developing PAOD more often than men. In the development of preventive strategies, modification of atherosclerotic risk factors, such as smoking, hypertension, and diabetes, should be the main goals.
Department of General Practice, Research Institute for Extramural and Transmural Health Care, Maastricht University, Maastricht, The Netherlands. jdhooi@zonnet.nl
J D
JD
Hooi
A D
AD
Kester
H E
HE
Stoffers
M M
MM
Overdijk
J W
JW
van Ree
J A
JA
Knottnerus
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D017678:Sex Distribution