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Published on: September 22, 2020
Infrapopliteal arterial occlusive disease in elderly men: a population based study
1Vascular Surgery Department, Hospital del Mar, Barcelona, Spain. aclara@imas.imim.es
Insights
Isolated infrapopliteal arterial disease is common in older men and linked to coronary heart disease (CHD). This condition, often asymptomatic, shares risk factors like smoking and diabetes with CHD.
Area of Science:
- Vascular Medicine
- Cardiology
- Epidemiology
Background:
- Peripheral arterial occlusive disease (PAOD) affects older adults.
- Infrapopliteal arterial disease is a specific manifestation of PAOD.
- Understanding its prevalence and associations is crucial for cardiovascular health.
Purpose of the Study:
- To determine the prevalence of isolated infrapopliteal PAOD in older men.
- To identify associated cardiovascular risk factors.
- To investigate the link between isolated infrapopliteal PAOD and coronary heart disease (CHD).
Main Methods:
- Cross-sectional study of 699 men aged 55-74.
- Collected data on cardiovascular history and risk factors.
- Utilized electrocardiogram and lower limb segmental pressures/waveforms.
Main Results:
- PAOD found in 13.4% of subjects; 39.4% had isolated infrapopliteal PAOD.
- Isolated infrapopliteal PAOD associated with older age, smoking, diabetes, and hypertriglyceridemia.
- Significant association (OR 1.8-3.4) between PAOD and CHD, regardless of PAOD pattern.
Conclusions:
- Isolated infrapopliteal PAOD is a frequent, often asymptomatic, condition in older men.
- It is strongly associated with both symptomatic and asymptomatic CHD.
- Risk factor profile differs from extended PAOD, primarily in smoking and lipid profile.
Aim:
The aim of this paper was to determine prevalence, cardiovascular risk factors and association with coronary heart disease (CHD) of isolated infrapopliteal arterial disease in old-adult men.
Design:
cross-sectional; participants: population-based sample of 699 men aged 55 to 74 years, measurements: cardiovascular history and risk factors, electrocardiogram, segmental pressures and velocity waveforms in lower limbs.
Results:
Peripheral arterial occlusive disease (PAOD) was observed in 13.4% subjects, of whom 39.4% (37 patients) had isolated infrapopliteal PAOD. Of these, 11 (29.7%) patients were symptomatic. Isolated infrapopliteal PAOD was significantly associated with increased age, smoking, diabetes and hypertriglyceridemia. Subjects with extended PAOD differed from those with isolated infrapopliteal PAOD in increased tobacco exposure, higher levels of LDL and lower levels of HDL cholesterol. Association between PAOD and CHD was almost always significant (odds ratio from 1.8 to 3.4) irrespective of PAOD topographic pattern and symptom characteristics of CHD subjects.
Conclusion:
Isolated infrapopliteal PAOD is a frequent asymptomatic disorder in old-adult men, clearly associated with both symptomatic and asymptomatic CHD. In contrast to an expected risk factor profile biased by clinical practice, these subjects only differed from those with PAOD significantly extended to proximal arteries in their smoking exposition and a more atherogenic lipid profile.
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