Incidence and risk factors of peripheral arterial occlusive disease in a prospective cohort of 700 adult elderly men followed for 5 years.
OBJECTIVE
This study was designed to assess the incidence of peripheral arterial occlusive disease (PAOD) in a population-based cohort of men aged 55-74 years and to establish a predictive function based on risk factors for the disease.


METHODS
This was a prospective study of 699 men representative of an urban population. Cardiovascular risk factors, history of cardiovascular events, and ankle-brachial index (ABI) at baseline and at 5 years were measured. PAOD was defined as a confirmed ABI <0.9.


RESULTS
A total of 468 (67%) subjects could be evaluated at 5 years. In the remaining 233 subjects, 94 had PAOD at baseline, 66 died during the study, and 73 were lost to follow-up. At the end of the 5-year study period, 56 (12%) subjects developed PAOD (21.4% ABI <0.6, 78.6% ABI between 0.61 and 0.9). Independent predictors for PAOD were age older than 70 years at baseline (odds ratio [OR] 2.5, P = 0.004), smoking history more than 40 pack-year (OR = 2.27, P = 0.007), history of cerebrovascular disease (OR = 3.49, P = 0.02), and symptomatic coronary disease (OR = 3.36, P = 0.004). The 5-year incidence of PAOD was 22.4% for subjects older than 70 years, 21.5% for heavy smokers, 29.4% for those with previous cerebrovascular events, and 25% for subjects with ischemic heart disease. The risk for PAOD in subjects without risk factors was 6%.


CONCLUSIONS
Twelve percent of adult men aged between aged 55 and 74 years developed PAOD during a follow-up of 5 years. Besides subjects with history of cardiovascular disease, men older than aged 70 years and heavy smokers constituted a high-risk group for PAOD and, therefore, the object of directed efforts of primary prevention.
Merino
Jana
J
Department of Angiology and Vascular Surgery, Hospital del Mar (Universitat Autònoma de Barcelona), Passeig Marítim 25-29, 08003, Barcelona, Spain. jmerino@tauli.cat
Planas
Adriana
A
Elosua
Roberto
R
de Moner
Ana
A
Gasol
Ana
A
Contreras
Carmen
C
Vidal-Barraquer
Francesc
F
Clarà
Albert
A
D000367:Age Factors; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000628:therapy; D050197:Atherosclerosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014505:Urban Population
J Clin Epidemiol. 2004 Mar;57(3):294-300
15066690
Am J Epidemiol. 2001 Apr 1;153(7):666-72
11282794
Int J Epidemiol. 1991 Jun;20(2):384-92
1917239
J Gen Intern Med. 2001 Jun;16(6):384-90
11422635
Arterioscler Thromb Vasc Biol. 1999 Mar;19(3):538-45
10073955
Arterioscler Thromb Vasc Biol. 1998 Feb;18(2):185-92
9484982
Circulation. 1985 Mar;71(3):510-5
3156006
Circulation. 1993 Sep;88(3):837-45
8353913
Am J Epidemiol. 1989 Jun;129(6):1110-9
2786328
Circulation. 1997 Jul 1;96(1):44-9
9236415
Int J Epidemiol. 1996 Dec;25(6):1172-81
9027521
Circulation. 1970 May;41(5):875-83
5444530
Clin Invest Med. 1991 Apr;14(2):93-100
2060193
Int J Obes Relat Metab Disord. 2001 Jul;25(7):1068-70
11443508
Eur J Vasc Endovasc Surg. 2008 Jul;36(1):71-6
18396072
Int J Epidemiol. 1996 Apr;25(2):282-90
9119553
JAMA. 2008 Jul 9;300(2):197-208
18612117
J Am Geriatr Soc. 1985 Jan;33(1):13-8
3965550
Circulation. 2006 Jan 24;113(3):388-93
16432070
Int Angiol. 1985 Jul-Sep;4(3):289-94
3831151
J Chronic Dis. 1981;34(6):261-9
7240365
J Vasc Surg. 2002 Mar;35(3):506-9
11877699