Occurrence of peripheral arterial disease in a Belgian cohort of patients with cardiovascular history of atherothrombosis.
BACKGROUND
Peripheral arterial disease (PAD) is an underestimated and under diagnosed disease with as much as 60% of the patients having at least one other vascular bed affected.


OBJECTIVE
The study aimed to evaluate the prevalence of PAD defined by different means in high risk Belgian ambulatory patients.


METHODS
Participating physicians were to include a least six consecutive high risk ambulant patients for atherothrombosis. Demographical data and cardiovascular risk factors were recorded. The Edinburgh Questionnaire was administered. A vascular examination, including palpation and blood pressure measurement of the relevant arteries was performed.


RESULTS
275 Belgian physicians included a total of 2831 patients with a mean age of 68.0 years. Sixty three point three percent (63.3%) of the patients had a history of coronary artery disease whereas 28.0% reported a history of cerebrovascular disease. Overall, 1777 patients (62.8%, 95% CI: 61-65%) had a PAD diagnosis with an even distribution among males and females and increasing with age. PAD, defined as an ABI (Ankle Brachial Index) < 0.9, was detected in 28.5% of the population. PAD defined as the presence of intermittent claudication with positive Edinburgh Questionnaire or as a history of peripheral vascular revascularisation, was detected in 12.4% and 8.1% of the population respectively. Sixty six point seven percent (66.7%) of the PAD patients reported walking pain. The presence of pulsation of the tibialis posterior and/or dorsalis pedis arteries was not predictive of an ABI > 0.9. In contrast, the absence of pulse of both arteries was correlated with an odds-ratio of 6.4 to 8.1 to find a pathological ABI.


CONCLUSIONS
The prevalence of PAD in ambulant patients with a history of coronary artery disease or cerebrovascular disease varied from 62.8% (composite of intermittent claudication with Edinburgh Questionnaire positive, history of peripheral vascular revascularisation, ABI < 0.9) to 28.5% (ABI < 0.9). Sixty six point seven percent (66.7%) of the PAD population reported walking pain. The absence of pulsation of the tibialis posterior and dorsalis pedis arteries was correlated with an ABI < 0.9.
Missault
L
L
Department of Cardiology, AZ Sint-Jan AV, Brugge.
Krygier
C
C
Lukito
G
G
Mary-Rabine
L
L
D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology*; D001530:Belgium / Q000453:epidemiology; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors