Prevalence, Progression and Associated Risk Factors of Asymptomatic Peripheral Arterial Disease

Nikita Mehta,Stephen Ogendo,Mark Awori

doi:10.4314/aas.v14i1.6

Abstract

Introduction: The prevalence of peripheral arterial disease (PAD) ranges between 4.5% and 57% and is independently associated with cardiovascular disease burden irrespective of symptoms. Two thirds of cases are thought to be asymptomatic and may go unrecognised. Local prevalence and natural progression of asymptomatic PAD is unknown. Methods : This one year, non-interventional longitudinal study, aimed to determine prevalence and progression of asymptomatic PAD in patients with cardiovascular risk factors. Results : Of 217 patients screened, 36% had asymptomatic disease in 113 legs. Of sixty two who returned for follow-up, eight normal legs developed asymptomatic PAD, and 46%, asymptomatic at baseline showed disease progression. Initial baseline ABI showed significant change over 1 year of follow-up (p=0.001) and 21% (13) of patients eventually developed intermittent claudication. Also, 52% of baseline asymptomatic participants having at least one associated cardiovascular risk factor showed disease progression over 1 year. Those developing claudication demonstrated significant ABI deterioration. Having two or more cardiovascular risk factors significantly affected progression of asymptomatic disease, (p = 0.031). Conclusion : Study confirms high prevalence of asymptomatic PAD in our population and significant disease progression in one year. Key words: Peripheral Artery Disease, Risk Factors, Asymptomatic, Disease Progression

Highlights

The prevalence of peripheral arterial disease (PAD) ranges between 4.5% and 57% and is independently associated with cardiovascular disease burden irrespective of symptoms
All consenting adults with asymptomatic peripheral arterial disease defined as abnormal Ankle Brachial Index (ABI) of less than or equal to 0.90 and no intermittent claudication on the Edinburgh questionnaire were included
More of the female subjects had a history of diabetes mellitus (44%) and hypertension (93%) compared to the males (Table 1)

Summary

Introduction

The prevalence of peripheral arterial disease (PAD) ranges between 4.5% and 57% and is independently associated with cardiovascular disease burden irrespective of symptoms. Methods: This one year, non-interventional longitudinal study, aimed to determine prevalence and progression of asymptomatic PAD in patients with cardiovascular risk factors. 52% of baseline asymptomatic participants having at least one associated cardiovascular risk factor showed disease progression over 1 year. Those developing claudication demonstrated significant ABI deterioration. Over two-thirds of PAD patients are asymptomatic, prevalence generally ranging from 2 to 39% [6] and slightly higher in African populations at approximately 71% [3], with a male to female ratio of 1:3-4 [5]. The natural history of PAD disease is not well understood progression is identical irrespective of

Objectives

Methods

Results

Discussion

Conclusion