Related Experiment Videos
The prevalence of asymptomatic and unrecognized peripheral arterial occlusive disease
H E Stoffers1, P E Rinkens, A D Kester
1Department of General Practice, University of Limburg, The Netherlands.
Insights
Many peripheral arterial occlusive disease (PAOD) cases remain undiagnosed by general practitioners (GPs). Early detection and intervention are crucial for preventing atherosclerosis progression.
Area of Science:
- Vascular Medicine
- Epidemiology
- Public Health
Background:
- Estimating the prevalence of peripheral arterial occlusive disease (PAOD) in a large population aged 45-74.
- Including asymptomatic and undiagnosed cases in the prevalence estimation.
Purpose of the Study:
- To determine the prevalence of PAOD in a general practice setting.
- To identify the proportion of PAOD cases unknown to general practitioners (GPs).
- To highlight the potential for improved secondary prevention of atherosclerosis.
Main Methods:
- A stratified sample of 3171 individuals from 18 general practice centers.
- Data collection included intermittent claudication, pulse assessment, vascular risk factors, and ankle-brachial systolic pressure ratio (AB ratio).
- PAOD defined as AB ratio < 0.95 on two occasions; results extrapolated to the total population.
Main Results:
- Overall PAOD prevalence was 6.9%, with 1.6% meeting WHO criteria.
- 22% of PAOD cases were symptomatic; prevalence increased with age, male gender, and lower AB ratio.
- 68% of PAOD cases were unknown to GPs, particularly less advanced atherosclerosis.
Conclusions:
- A significant proportion of PAOD cases, especially asymptomatic ones, are unrecognized by GPs.
- Enhanced GP efforts in screening and early detection can improve secondary prevention of atherosclerosis.
- Targeted screening in individuals with risk factors may identify more PAOD cases.
Background:
The prevalence of peripheral arterial occlusive disease (PAOD), including asymptomatic cases and cases unknown to the general practitioner (GP) was estimated in 18,884 men and women, aged 45-74 years, on the list of 18 general practice centres (GPC).
Methods:
The study population (n = 3171) consisted of a stratified sample of the total population. In the GPC data were collected on intermittent claudication (IC), peripheral pulses, vascular risk factors, cardio- and cerebrovascular disease (CCVD) and the ankle brachial systolic pressure ratio (AB ratio) and PAOD was defined as an AB ratio < 0.95 on two consecutive occasions. Results were recalculated for the total population.
Results:
The prevalence of PAOD was 6.9 percent (95 percent Cl:5.2-7.9 percent), a quarter of which (1.6 percent) met the classic WHO criteria. Peripheral arterial occlusive disease did not occur significantly more often among men than among women but men suffered more often from an advanced stage of PAOD. Of all PAOD cases, 22 percent were symptomatic. The proportion of symptomatic cases correlated positively with higher age, male gender and lower AB ratio. Among asymptomatic PAOD cases the prevelance of concomitant CCVD was three to four times as high as in the group of subjects without PAOD. Of all PAOD cases 68 percent were unknown to the GP and this group mainly represented less advanced cases of atherosclerosis. However, among PAOD cases with an AB ratio <0.75, 42 percent were unknown to the GP.
Conclusions:
Our data on asymptomatic and unknown PAOD cases show that GPs can still enhance their efforts towards (secondary) prevention of atherosclerosis.