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

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 conducted on a total of 10,000 subjects aged ≥40 years, from 36 municipalities. An ankle-brachial index (ABI) ≤ 0.9 in either leg was used as 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 with hypertension (OR 4.6; 95% CI; 3.42-6.20), diabetes (4.3; 3.17-5.75), dyslipidaemia (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, dyslipidaemia, 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, dyslipidaemia, and obesity, but not smoking were strong predictors of PAD. ABI measurement should be routinely performed as a screening test in intermediate and high-risk patients for CVD prevention. This could lead to an 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.