Prevalence of peripheral artery disease in the elderly population in urban and rural areas of Central Africa: the EPIDEMCA study.
OBJECTIVE
Data on peripheral artery disease in Africa are sparse and limited to urban areas. Given the urban/rural socio-economical gradient in these countries, we sought to determine the prevalence and risk factors of peripheral artery disease in urban and rural areas of two countries in Central Africa.


METHODS
Individuals ≥65 years old living in two urban and rural areas of the Republic of Central Africa (ROC) and the Central African Republic (CAR) were invited. Demographic, clinical and biological data were collected. Ankle-brachial index ≤0.90 defined peripheral artery disease.


RESULTS
Among the 1871 participants (age 73 years, 62% female) the prevalence of peripheral artery disease was 14.8%, higher in ROC than in CAR (17.4% vs. 12.2%, p = 0.007) and higher in females than males (16.6% vs. 11.9%, p = 0.012). The prevalence of peripheral artery disease increased with age, respectively at 10.9%, 14.9%, 15.1% and 22.2% for age bands of 65-69, 70-74, 75-79 and 80+years (p < 0.001). Higher rates of peripheral artery disease were found in urban areas in ROC (20.7% vs. 14.4% in rural areas, p = 0.011), but not in CAR (11.5% vs. 12.9%, p = NS). In multivariate analysis, peripheral artery disease was significantly associated with age (odds ratio (OR): 1.03; p = 0.004), dyslipidaemia (OR: 1.88; p = 0.003), smoking (OR: 1.78; p = 0.003), obesity (OR: 1.98; p = 0.034) and underweight (OR: 1.49; p = 0.023). Regular alcohol drinking was associated with decreased risk of peripheral artery disease (OR: 0.73; p = 0.044).


CONCLUSIONS
The prevalence of peripheral artery disease in the elderly is high in Africa, especially in females. In ROC, with a higher urban-rural socio-economic gradient, peripheral artery disease is more frequent in the urban areas.
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France ileana.desormais@orange.fr.
Ileana
I
Desormais
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Cardiology, Dupuytren University Hospital, Limoges, France.
Victor
V
Aboyans
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France.
Maëlenn
M
Guerchet
Department of Neurology, Brazzaville University Hospital, Republic of Congo.
Bébène
B
Ndamba-Bandzouzi
Department of Neurology, Amitié Hospital, Bangui, Central African Republic.
Pascal
P
Mbelesso
EA 6310, Disability, Activity, Aging, Autonomy and the Environment (HAVAE), Limoges, France Department of Geriatrics, Dupuytren University Hospital, Limoges, France.
Thierry
T
Dantoine
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Cardiology, Dupuytren University Hospital, Limoges, France.
Dania
D
Mohty
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Dupuytren University Hospital, Limoges, France.
Benoît
B
Marin
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Dupuytren University Hospital, Limoges, France.
Pierre Marie
PM
Preux
INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, France Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France.
Philippe
P
Lacroix
D000350:Africa, Central / Q000453:epidemiology; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014504:Urban Health
Ankle-brachial index; elderly; epidemiology Africa; peripheral artery disease