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Arch Cardiol Mex. 2017 Jun 13. pii: S1405-9940(17)30011-3. doi: 10.1016/j.acmx.2017.02.002. [Epub ahead of print]

Prevalence and risk factors associated to peripheral arterial disease in an adult population from Colombia.

Author information

1
Department of Physiological Sciences, Faculty of Health Sciences, University of Cauca, Popayán, Colombia; Molecular Diagnostics Unit, InnovaGen Foundation, Popayán, Colombia.
2
Department of Physiological Sciences, Faculty of Health Sciences, University of Cauca, Popayán, Colombia; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
3
Department of Surgery, Faculty of Health Sciences, University of Cauca, Popayán, Colombia.
4
Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
5
Department of Physiological Sciences, Faculty of Health Sciences, University of Cauca, Popayán, Colombia. Electronic address: hsierra@unicauca.edu.co.

Abstract

BACKGROUND:

Cardiovascular diseases (CVD) are the most important cause of mortality in Latin America while peripheral arterial disease (PAD) is the third leading cause of atherosclerotic cardiovascular morbidity.

OBJECTIVE:

To establish the prevalence of PAD and the distribution of traditional CVD risk factors in a population from the Department of Cauca, Colombia.

METHODS:

A cross-sectional study was performed in a total of 10,000 subjects aged ≥40 years from 36 municipalities. An ankle-brachial index (ABI) ≤0.9 in either leg was used diagnostic criterion of PAD.

RESULTS:

Overall PAD prevalence was 4.4% (4.7% females vs. 4.0% males), with diabetes being the most prevalent risk factor (23%). Among individuals self-reporting a history of acute myocardial infarction or stroke, PAD prevalence was 31.0% and 8.1%, respectively. After adjusting for potential confounders, PAD was significantly associated to hypertension (OR 4.6; 95% CI 3.42-6.20), diabetes (4.3; 3.17-5.75), dyslipidemia (3.1; 2.50-3.88), obesity (1.8; 1.37-2.30) and cigarette smoking (1.6; 1.26-1.94). Analysis for the interaction of risk factors showed that diabetes, dyslipidemia and obesity accounted for 13.2 times the risk for PAD (6.9-25.4), and when adding hypertension to the model, the risk effect was the highest (17.2; 8.4-35.1).

CONCLUSIONS:

Hypertension, diabetes, dyslipidemia, and obesity but not smoking were strong predictors of PAD. ABI measurement should be routinely conducted as a screening test in intermediate and high-risk patients for CVD prevention. This will allow for early intervention and follow up on populations at risk, thus, contributing to improve strategies for reducing CVD burden.

KEYWORDS:

Ankle brachial index; Colombia; Diabetes; Enfermedad arterial periférica; Hipertensión; Hypertension; Obesidad; Obesity; Peripheral arterial disease; Índice tobillo-brazo

PMID:
28623035
DOI:
10.1016/j.acmx.2017.02.002
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