The magnitude of the problem of peripheral arterial disease: epidemiology and clinical significance.
The prevalence of lower extremity peripheral arterial disease (PAD) varies across populations, based on the groups studied and the detection methods used. The ankle-brachial index (ABI) is a more sensitive tool for PAD detection than is screening for intermittent claudication (IC); only about 10% to 30% of patients diagnosed with PAD based on the ABI have classic symptoms of IC. The prevalence of PAD increases markedly with older age and in persons with diabetes or a history of smoking; prevalence also is elevated in persons with hyperlipidemia, hypertension, or chronic kidney disease. PAD is more prevalent in primary care medical practices than in community-dwelling populations. PAD (defined as an ABI < 0.90) is associated with a twofold to three-fold increased risk of cardiovascular mortality. Borderline and low-normal ABI values, as well as elevated ABI values (> 1.30 or > 1.40), are increasingly recognized as being associated with elevated cardiovascular mortality. Persons with PAD have significantly increased functional impairment and elevated rates of functional decline relative to those without PAD.
McDermott
Mary McGrae
MM
Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. mdm608@northwestern.edu
D000203:Activities of Daily Living; D002318:Cardiovascular Diseases / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D016138:Walking / Q000502:physiology