High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study

被引:587
作者
Diehm, C
Schuster, A
Allenberg, JR
Darius, H
Haberl, R
Lange, S
Pittrow, D
von Stritzky, B
Tepohl, G
Trampisch, HJ
机构
[1] Heidelberg Univ, Affiliated Teaching Hosp, Dept Internal Med, D-76307 Karlsbad, Germany
[2] 3P Consulting, D-82393 Pocking, Germany
[3] Heidelberg Univ, Vasc Surg Sect, Dept Vasc Surg, D-69120 Heidelberg, Germany
[4] Klinikum Berlin Neukolln, Vivantes Netwerk Gesundheit, Dept Med, D-12313 Berlin, Germany
[5] Stadt Krankenhaus Munchen Harlaching, Dept Neurol, D-81545 Munich, Germany
[6] Ruhr Univ Bochum, Dept Med Informat Biometry & Epidemiol, D-44780 Bochum, Germany
[7] Tech Univ Dresden, Fac Med, Dept Clin Pharmacol, D-01307 Dresden, Germany
[8] Sanofi Synthelabo, Dept Med, D-10785 Berlin, Germany
关键词
peripheral arterial disease; atherothrombosis; ankle brachial index; primary care; prevalence; cross-sectional study; epidemiology;
D O I
10.1016/S0021-9150(03)00204-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We aimed to obtain reliable data on the epidemiology, co-morbidities and risk factor profile of peripheral arterial disease (PAD) in general medical practise. In the cross-sectional part of the observational German Epidemiological Trial on Ankle Brachial Index (getABI study), 344 general practitioners throughout Germany determined the ABI of consecutive, unselected patients aged 65 years or older with bilateral Doppler ultrasound measurements. Additional assessments comprised patient history with the focus on atherothrombotic diseases, physical examination. and the WHO questionnaire on intermittent claudication. A total of 6880 patients were included (42.0% male, mean age 72.5 years, mean body mass index 27.3 kg/m(2), mean systolic/diastolic blood pressure 143.7/81.3 mmHg). The prevalence of PAD for men/women as indicated by an ankle brachial index (AB1) < 0.9 was 19.8/16.8%. Patients with PAD were slightly older than patients without PAD, suffered more frequently from diabetes (36.6 vs. 22.6%; adjusted OR: 1.8), hypertension (78.8 vs. 61.6%; OR: 2.2), lipid disorders (57.2 vs. 50.7%; OR: 1.3) and other coexisting atherothrombotic diseases (any cerebrovascular event: 15.0 vs. 7.6%; OR: 1.8; any cardiovascular event: 28.9 vs. 17.0%; OR: 1.5). The data highlight the high prevalence of PAD in primary care. PAD patients are characterised by a high co-morbidity, particularly with regard to other manifestations of atherothrombosis. Doppler ultrasound measurement for ABI determinations is a non-invasive, inexpensive, reliable tool in primary care and enables GPs to identify patients at risk of PAD. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:95 / 105
页数:11
相关论文
共 29 条
[1]  
*ARB EP METH DTSCH, 2000, LEITL EMPF SICH GUT
[2]   Critical issues in peripheral arterial disease detection and management - A call to action [J].
Belch, JJF ;
Topol, EJ ;
Agnelli, G ;
Bertrand, M ;
Califf, RM ;
Clement, DL ;
Creager, MA ;
Easton, JD ;
Gavin, JR ;
Greenland, P ;
Hankey, G ;
Hanrath, P ;
Hirsch, AT ;
Meyer, J ;
Smith, SC ;
Sullivan, F ;
Weber, MA .
ARCHIVES OF INTERNAL MEDICINE, 2003, 163 (08) :884-892
[3]  
Criqui M H, 1996, Vasc Med, V1, P65
[4]   THE SENSITIVITY, SPECIFICITY, AND PREDICTIVE VALUE OF TRADITIONAL CLINICAL-EVALUATION OF PERIPHERAL ARTERIAL-DISEASE - RESULTS FROM NONINVASIVE TESTING IN A DEFINED POPULATION [J].
CRIQUI, MH ;
FRONEK, A ;
KLAUBER, MR ;
BARRETTCONNOR, E ;
GABRIEL, S .
CIRCULATION, 1985, 71 (03) :516-522
[5]   MORTALITY OVER A PERIOD OF 10 YEARS IN PATIENTS WITH PERIPHERAL ARTERIAL-DISEASE [J].
CRIQUI, MH ;
LANGER, RD ;
FRONEK, A ;
FEIGELSON, HS ;
KLAUBER, MR ;
MCCANN, TJ ;
BROWNER, D .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (06) :381-386
[6]   A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) [J].
Gent, M ;
Beaumont, D ;
Blanchard, J ;
Bousser, MG ;
Coffman, J ;
Easton, JD ;
Hampton, JR ;
Harker, LA ;
Janzon, L ;
Kusmierek, JJE ;
Panak, E ;
Roberts, RS ;
Shannon, JS ;
Sicurella, J ;
Tognoni, G ;
Topol, EJ ;
Verstraete, M ;
Warlow, C .
LANCET, 1996, 348 (9038) :1329-1339
[7]  
*GETABI STUD GROUP, 2002, VASA, V4, P241
[8]  
Greenland P, 2000, CIRCULATION, V101, P723
[9]   Meeting the challenge of peripheral arterial disease [J].
Halperin, JL ;
Fuster, V .
ARCHIVES OF INTERNAL MEDICINE, 2003, 163 (08) :877-878
[10]   The Minnesota Regional Peripheral Arterial Disease Screening Program: toward a definition of community standards of care [J].
Hirsch, AT ;
Halverson, SL ;
Treat-Jacobson, D ;
Hotvedt, PS ;
Lunzer, MM ;
Krook, S ;
Rajala, S ;
Hunninghake, DB .
VASCULAR MEDICINE, 2001, 6 (02) :87-96