title: Peripheral Arterial Disease Incidence and Associated Risk Factors in a Mediterranean Population-based Cohort. The REGICOR Study.
abstract: The reported incidence of lower extremity peripheral arterial disease (PAD) in Western countries ranges between 530 and 2,380 per 100,000 person years. The aims of this study were to determine the incidence of PAD and identify associated risk factors in a Mediterranean population.
  
  
  
  Cardiovascular risk factors, the Edinburgh questionnaire, and ankle brachial index (ABI) were collected from 5,434 individuals, aged 35-79 years, from a population based cohort study at baseline and after a mean of 5.7 years follow up. PAD was defined as ABI <0.9 or a clinical diagnosis during follow up. Logistic and regression tree analyses were used to identify factors associated with PAD.
  
  
  
  In total, 118 new cases of confirmed PAD were identified. The cumulative population incidence rate of PAD was 377 cases per 100,000 person years. For symptomatic PAD, this figure was 102 per 100,000 person years. The most important risk factors for PAD were current (OR 2.30; 95% CI 1.27-4.16) or former smoking (OR 2.02; 95% CI 1.19-3.43), diabetes (OR 1.78; 95% CI 1.17-2.72), age (OR 1.04; 95% CI 1.02-1.07), history of cardiovascular disease (OR 2.06; 95% CI 1.22-3.51), triglycerides level (OR 1.56; 95% CI 1.07-2.29), and systolic blood pressure (OR 1.02; 95% CI 1.01-1.03). In the population ≤65 years the most relevant risk factor was diabetes, whereas in those >65 years smoking was the leading factor. Long-term uncontrolled diabetes was the strongest risk factor for PAD (OR 10.14; 95% CI 3.57-28.79).
  
  
  
  The incidence of lower extremity PAD is lower in the Mediterranean area than has been reported for other areas. The data suggest that patients with long-term uncontrolled diabetes and former and current smokers older than 65 years should be considered for PAD screening.
authors.affiliation: Angiology and Vascular Surgery Department, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Autònoma de Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Velescu
authors.affiliation: Angiology and Vascular Surgery Department, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Autònoma de Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Clara
authors.affiliation: Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Peñafiel
authors.affiliation: Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Grau
authors.affiliation: Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: I R
authors.initials: IR
authors.lastname: Degano
authors.affiliation: Research Unit, Family Medicine, Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Girona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Martí
authors.affiliation: Research Unit, Family Medicine, Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol), Girona, Spain; TransLab Research Group, Department of Medical Sciences, School of Medicine, University of Girona, Girona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Marrugat
authors.affiliation: Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. Electronic address: relosua@imim.es.
authors.forename: R
authors.initials: R
authors.lastname: Elosua
mesh_terms: D055109:Ankle Brachial Index; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D058729:Peripheral Arterial Disease / Q000175:diagnosis*; D015995:Prevalence; D012307:Risk Factors
keywords: Ankle brachial index; Peripheral arterial disease