Asymptomatic peripheral arterial occlusive disease predicted cardiovascular morbidity and mortality in a 7-year follow-up study

• Published in: Journal of clinical epidemiology 2004-03, Vol.57 (3), p.294-300
• Main Authors: Hooi, J.D, Kester, A.D.M, Stoffers, H.E.J.H, Rinkens, P.E.L.M, Knottnerus, J.A, van Ree, J.W
• Format: Article
• Language: English
• Subjects: Adult; Aged; Ankle-brachial pressure index; Arteriosclerosis - complications; Arteriosclerosis - mortality; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular morbidity; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Epidemiology; Female; Follow-Up Studies; General aspects; Heart attacks; Humans; Incidence; Male; Medical sciences; Middle Aged; Morbidity; Mortality; Netherlands - epidemiology; Older people; Peripheral arterial occlusive disease; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - mortality; Prognosis; Sex Factors; Studies
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2003.09.003

Asymptomatic peripheral arterial occlusive disease (PAOD) is a common atherosclerotic disorder among the elderly population. Scarce data are available on the risk of nonfatal and fatal cardiovascular diseases in these subjects. We investigated cardiovascular morbidity and mortality of asymptomatic PAOD subjects. A sample of 3649 subjects (40–78 years of age) was selected in collaboration with 18 general practice centers and followed up after the initial screening (mean follow-up time 7.2 years). Asymptomatic PAOD was determined by means of the ankle-brachial pressure index (ABPI). Main outcome measures were nonfatal cardiovascular events and mortality. Cox proportional hazard models showed that asymptomatic PAOD was significantly associated with cardiovascular morbidity (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.3–2.1), total mortality (HR 1.4, 95% CI 1.1–1.8), and cardiovascular mortality (HR 1.5, 95% CI 1.1–2.1). Asymptomatic PAOD is a significant predictor of cardiovascular morbidity and mortality. In high-risk subjects, measurement of the ABPI provides valuable information on future cardiovascular events.