Circulation, Vol 71, 510-515, Copyright © 1985 by American Heart Association
MH Criqui, A Fronek, E Barrett-Connor, MR Klauber, S Gabriel and D Goodman
Because patients with peripheral arterial disease (PAD) may be asymptomatic
or may present with atypical symptoms or findings, the true population
prevalence of PAD is essentially unknown. We used four highly reliable,
sophisticated noninvasive tests (segmental blood pressure, flow velocity by
Doppler ultrasound, postocclusive reactive hyperemia, and pulse
reappearance half-time) to assess the prevalence of large-vessel PAD and
small-vessel PAD in an older (average age 66 years) defined population of
613 men and women. A total of 11.7% of the population had large-vessel PAD
on noninvasive testing, and nearly half of those with large-vessel PAD also
had small-vessel PAD (5.2%). An additional 16.0% of the population had
isolated small-vessel PAD. Large- vessel PAD increased dramatically with
age and was slightly more common in men and in subjects with
hyperlipidemia. Isolated small-vessel PAD, by contrast, was essentially
unrelated to sex, hyperlipidemia, or age, although it was somewhat less
common before age 60. Intermittent claudication rates in this population
were 2.2% in men and 1.7% in women, and abnormalities in femoral or
posterior tibial pulse were present in 20.3% of men and 22.1% of women
compared with the noninvasively assessed large-vessel PAD rate of 11.7%.
Thus assessment of large-vessel PAD prevalence by intermittent claudication
dramatically underestimated the true large-vessel PAD prevalence and
assessment by peripheral pulse examination dramatically overestimated the
true prevalence.
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The prevalence of peripheral arterial disease in a defined population
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J. J. F. Belch, E. J. Topol, |