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[The importance of peripheral-arterial occlusive diseases in medical practice. Conclusions from the Basel study]
Insights
Occlusive peripheral artery disease (OPAD) is highly prevalent in men aged 35-64, with risk factors significantly predicting incidence. OPAD patients face increased mortality, primarily from coronary heart disease, highlighting the need for risk factor intervention.
Area of Science:
- Epidemiology
- Vascular Medicine
- Public Health
Context:
- Prospective epidemiological studies examining occlusive peripheral artery disease (OPAD) in general practice.
- Focus on men aged 35-64, assessing incidence and risk factors.
Purpose:
- To present tentative conclusions on the role of OPAD in general practice.
- To evaluate the predictability of OPAD by risk profiles.
- To assess morbidity and mortality associated with OPAD.
Summary:
- The 5-year incidence of OPAD in men aged 35-64 was 76%, three times higher than intermittent claudication.
- A risk profile at entry predicted new OPAD occurrences; men with 3 risk factors had 114% incidence versus 20% for those without.
- An 11-year follow-up showed 3% amputations but a 33% excess mortality in OPAD patients versus 11% in controls, mainly due to coronary heart disease.
Impact:
- High correlation between risk profile and morbidity/mortality underscores the necessity of risk factor management.
- Discusses the efficacy of risk profile improvement and cardiovascular mortality reduction strategies, referencing the 'Mister Fit Study'.
Abstract:
Based on prospective epidemiological studies, tentative conclusions concerning the place of occlusive peripheral artery disease ( OPAD ) in general practice are presented. For men aged 35-64 the 5-year incidence of OPAD was found to be 76%, i.e. 3 times higher than that of intermittent claudication. In a high percentage of cases new occurrences of OPAD were predictable by the risk profile at entry. Men with 3 risk factors had an incidence of 114% compared to 20% in those free of risk at entry. A comparative 11-year follow-up of 273 men with OPAD and 273 age-matched, randomly selected controls without OPAD , revealed a moderate incidence of local complications (3% amputations) but an impressive excess mortality of 33% vs 11%, mainly due to coronary heart disease. The high correlation between the risk profile on the one hand and morbidity/mortality on the other emphasizes the need for action against risk factors. The efficacy of measures for the improvement of the risk profile and the reduction of cardiovascular mortality is discussed on the basis of the so-called " Mister Fit Study".