Incidence and risk factors of peripheral arterial occlusive disease in a prospective cohort of 700 adult elderly men followed for 5 years.

Abstract

This study was designed to assess the incidence of peripheral arterial occlusive disease (PAOD) in a population-based cohort of men aged 55-74 years and to establish a predictive function based on risk factors for the disease. This was a prospective study of 699 men representative of an urban population. Cardiovascular risk factors, history of cardiovascular events, and ankle-brachial index (ABI) at baseline and at 5 years were measured. PAOD was defined as a confirmed ABI <0.9. A total of 468 (67%) subjects could be evaluated at 5 years. In the remaining 233 subjects, 94 had PAOD at baseline, 66 died during the study, and 73 were lost to follow-up. At the end of the 5-year study period, 56 (12%) subjects developed PAOD (21.4% ABI <0.6, 78.6% ABI between 0.61 and 0.9). Independent predictors for PAOD were age older than 70 years at baseline (odds ratio [OR] 2.5, P = 0.004), smoking history more than 40 pack-year (OR = 2.27, P = 0.007), history of cerebrovascular disease (OR = 3.49, P = 0.02), and symptomatic coronary disease (OR = 3.36, P = 0.004). The 5-year incidence of PAOD was 22.4% for subjects older than 70 years, 21.5% for heavy smokers, 29.4% for those with previous cerebrovascular events, and 25% for subjects with ischemic heart disease. The risk for PAOD in subjects without risk factors was 6%. Twelve percent of adult men aged between aged 55 and 74 years developed PAOD during a follow-up of 5 years. Besides subjects with history of cardiovascular disease, men older than aged 70 years and heavy smokers constituted a high-risk group for PAOD and, therefore, the object of directed efforts of primary prevention.