Prevalence of peripheral artery disease (PAD) and factors associated: An epidemiological analysis from the population-based Screening PRE-diabetes and type 2 DIAbetes (SPREDIA-2) study

PLoS One. 2017 Oct 26;12(10):e0186220. doi: 10.1371/journal.pone.0186220. eCollection 2017.

Abstract

Aim: To describe the prevalence of Peripheral Artery Disease (PAD) in a random population sample and to evaluate its relationship with Mediterranean diet and with other potential cardiovascular risk factors such as serum uric acid and pulse pressure in individuals ranged 45 to 74 years.

Methods: Cross-sectional analysis of 1568 subjects (mean age 6.5 years, 43% males), randomly selected from the population. A fasting blood sample was obtained to determine glucose, lipids, and HbA1C levels. An oral glucose tolerance test was performed in non-diabetic subjects. PAD was evaluated by ankle-brachial index and/or having a prior diagnosis.

Results: PAD prevalence was 3.81% (95% CI, 2.97-4.87) for all participants. In men, PAD prevalence was significantly higher than in women [5.17% (95% CI, 3.74-7.11) vs. 2.78% (95% CI, 1.89-4.07); p = 0.014]. Serum uric acid in the upper quartile was associated with the highest odds ratio (OR) of PAD (for uric acid > 6.1 mg/dl, OR = 4.31; 95% CI, 1.49-12.44). The remaining variables more strongly associated with PAD were: Heart rate >90 bpm (OR = 4.16; 95%CI, 1.62-10.65), pulse pressure in the upper quartile (≥ 54 mmHg) (OR = 3.82; 95%CI, 1.50-9.71), adherence to Mediterranean diet (OR = 2.73; 95% CI, 1.48-5.04), and former smoker status (OR = 2.04; 95%CI, 1.00-4.16).

Conclusions: Our results show the existence of a low prevalence of peripheral artery disease in a population aged 45-74 years. Serum uric acid, pulse pressure and heart rate >90 bpm were strongly associated with peripheral artery disease. The direct association between Mediterranean diet and peripheral artery disease that we have found should be evaluated through a follow-up study under clinical practice conditions.

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / epidemiology*
  • Prediabetic State / complications
  • Prediabetic State / diagnosis*

Grants and funding

This work was funded by the Agencia Laín Entralgo (Consejería de Sanidad de la Comunidad de Madrid) Grant ‘RS_AP10/6’ and by FIS (Fondo de Investigaciones Sanitarias, Instituto de la Salud Carlos III) grants no. 12/01806 and 15/00259 and co-financied by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.