title: Asymptomatic peripheral arterial occlusive disease predicted cardiovascular morbidity and mortality in a 7-year follow-up study.
abstract: OBJECTIVE
  Asymptomatic peripheral arterial occlusive disease (PAOD) is a common atherosclerotic disorder among the elderly population. Scarce data are available on the risk of nonfatal and fatal cardiovascular diseases in these subjects. We investigated cardiovascular morbidity and mortality of asymptomatic PAOD subjects.
  
  
  METHODS
  A sample of 3649 subjects (40-78 years of age) was selected in collaboration with 18 general practice centers and followed up after the initial screening (mean follow-up time 7.2 years). Asymptomatic PAOD was determined by means of the ankle-brachial pressure index (ABPI). Main outcome measures were nonfatal cardiovascular events and mortality.
  
  
  RESULTS
  Cox proportional hazard models showed that asymptomatic PAOD was significantly associated with cardiovascular morbidity (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.3-2.1), total mortality (HR 1.4, 95% CI 1.1-1.8), and cardiovascular mortality (HR 1.5, 95% CI 1.1-2.1).
  
  
  CONCLUSIONS
  Asymptomatic PAOD is a significant predictor of cardiovascular morbidity and mortality. In high-risk subjects, measurement of the ABPI provides valuable information on future cardiovascular events.
authors.affiliation: Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.
authors.forename: J D
authors.initials: JD
authors.lastname: Hooi
authors.forename: A D M
authors.initials: AD
authors.lastname: Kester
authors.forename: H E J H
authors.initials: HE
authors.lastname: Stoffers
authors.forename: P E L M
authors.initials: PE
authors.lastname: Rinkens
authors.forename: J A
authors.initials: JA
authors.lastname: Knottnerus
authors.forename: J W
authors.initials: JW
authors.lastname: van Ree
mesh_terms: D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000150:complications* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012737:Sex Factors