Men At Risk: Peripheral Artery Disease
(Ivanhoe Newswire) –A study that involved nearly 45,000 men for over two decades has now found that those who smoke, have hypertension, high cholesterol, and type 2 diabetes have a greater risk of developing peripheral artery disease (PAD).
According to the study, “Peripheral artery disease is a distinct atherosclerotic syndrome marked by stenosis or occlusion [blockage] of the arteries, particularly of the lower extremities. PAD affects 8 to 10 million individuals in the United States, and is associated with reduced functional capacity and increased risk for cardiovascular morbidity and mortality. Despite its widespread prevalence and negative associations with quality of life, morbidity, and mortality, PAD remains underdiagnosed and undertreated.”
Michel M. Joosten, Ph.D., of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, and colleagues conducted a study to estimate the individual and cumulative associations of the 4 conventional cardiovascular risk factors of smoking, hypertension, hypercholesterolemia, and type 2 diabetes with the risk of PAD among men. The study included 44,985 men in the United States without a history of cardiovascular disease at the beginning of the study in 1986; participants in the Health Professionals Follow-up Study were followed up for 25 years until January 2011. The presence of risk factors was updated every two years during follow-up.
During a midpoint follow-up of 24.2 years, there were 537 cases of incident PAD. The researchers found that each risk factor was significantly and independently associated with a higher risk of PAD after adjustment for the other 3 risk factors and confounders. Regardless of duration category, all men with a risk factor had higher risks of developing PAD compared with men without risk factors. Each additional risk factor approximately doubled the risk for PAD. Men who did not have any of the 4 risk factors had a 77 percent lower risk for developing PAD compared with all other men in the group. In 96 percent of PAD cases, at least 1 of the 4 risk factors was present at the time of PAD diagnosis.
Risk of PAD tended to increase with duration of both type 2 diabetes and hypercholesterolemia. Among men with a positive history of hypertension, risk of PAD was higher among men who reported use of 1 antihypertensive drug or 2 or more antihypertensive drugs compared with men with hypertension who did not report current use of antihypertensive drugs. Cumulative intensity of smoking demonstrated a graded relationship with risk.
"In conclusion, in this well-characterized cohort of U.S. men followed up for longer than 2 decades, smoking, hypertension, hypercholesterolemia, and type 2 diabetes each demonstrated strong, graded, and independent associations with risk of clinically significant PAD," the authors were quoted as saying.
Source: JAMA, October 2012