Prevalence, correlates, and prognosis of peripheral artery disease in rural ecuador-rationale, protocol, and phase I results of a population-based survey: an atahualpa project-ancillary study.

Oscar H Del Brutto,Mark J Sedler,Kelsie J Phelan,Victor J Del Brutto,Pablo R Castillo,Robertino M Mera,Mauricio Zambrano,Elizabeth H Cusick,David L Brown,Jadry A Gruen

doi:10.1155/2014/643589

Abstract

Background. Little is known on the prevalence of peripheral artery disease (PAD) in developing countries. Study design. Population-based study in Atahualpa. In Phase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. In Phase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. In Phase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes. Results. During Phase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). A poor cardiovascular health status was noticed in 464 (70%) persons of which 27 (4%) had a stroke and 14 (2%) had ischemic heart disease. Forty-four subjects (7%) had suspected symptomatic PAD and 170 (26%) had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD. Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region.

Highlights

Underserved populations of Latin America are going through a process of epidemiologic transition due to increases in life expectancy and changes in dietary habits and lifestyles [1]
Most cohort studies have been conducted in the developed world; little longitudinal information is available from the few cross-sectional surveys assessing peripheral artery disease (PAD) prevalence in low- and middle-income countries [12,13,14,15]
Phase II (Confirmation of Suspected Cases of PAD). For this phase of the study, trained medical students—under the supervision of a certified cardiologist—will perform the ankle-brachial index (ABI) in all persons who were suspected to have symptomatic (ECQ positive) and asymptomatic PAD during Phase I and in a random sample of a similar number of negative individuals that will be matched by age and sex with suspected cases

Summary

Background

Little is known on the prevalence of peripheral artery disease (PAD) in developing countries. In Phase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. In Phase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. During Phase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region

Introduction

Methods

Findings

Discussion