The prevalence of peripheral arterial disease in a defined population.

Abstract

Because patients with peripheral arterial disease (PAD) may be asymptomatic or may present with atypical symptoms or findings, the true population prevalence of PAD is essentially unknown. We used four highly reliable, sophisticated noninvasive tests (segmental blood pressure, flow velocity by Doppler ultrasound, postocclusive reactive hyperemia, and pulse reappearance halftime) to assess the prevalence of large-vessel PAD and small-vessel PAD in an older (average age 66 years) defined population of 613 men and women. A total of 11. 7% of the population had large-vessel PAD on noninvasive testing, and nearly half of those with large-vessel PAD also had small-vessel PAD (5.2%). An additional 16.0% of the population had isolated small-vessel PAD. Large-vessel PAD increased dramatically with age and was slightly more common in men and in subjects with hyperlipidemia. Isolated small-vessel PAD, by contrast of PAD by the traditional methods, intermittent claudication and pulse palpation. MethodsAll 624 subjects were members of a geographically defined population initially studied under a Lipid Research Clinics (LRC) protocol.20 21 Subjects were recruited for the study with an introductory letter, followed by a telephone call to schedule an appointment. About half of the subjects (5 1.7%) were from a random sample of the LRC cohort and-the others were selected from the same earlier study for hyperlipidemia, defined as being at or above age-and sex-specific 90th percentiles for cholesterol concentration or 95th percentiles for triglyceride concentration or use of lipid-lowering medications. Subjects were from a predominantly white, upper-middle-class community in southern California, and informed consent was obtained after the procedures had been fully explained.Eleven subjects (1.8%) were excluded because of missing data or unreliable results of noninvasive testing. Two hundred seventy-five men and 338 women ranging in age from 38 to 82 years (mean 66) remained. One hundred fifty-eight subjects were 38 to 59 years old, 161 were 60 to 69 years old, and 294 were 70 to 82 years old.Criteria

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