Prevalence of peripheral arterial disease – results of the Heinz Nixdorf Recall Study

European Journal of Epidemiology (2006) 21: 279–285 | DOI 10.1007/s10654-006-0015-9 | © Springer 2006
– Knut Kröger, Andreas Stang, Jana Kondratieva, Susanne Moebus, Eva Beck, Axel Schmermund, Stefan Möhlenkamp, Nico Dragano, Johannes Siegrist, Karl-Heinz Jöckel & Raimund Erbel on behalf of the Heinz Nixdorf Recall Study Group-

kroeger_2006-EurJetEpid-Tab1Background: This report presents population-based estimates of the prevalence of peripheral arterial disease (PAD), chronic critical limb ischemia (CLI), and Moenckeberg’s medial calcinosis (MC) in Germany. Patients and methods: From the year 2000 to 2003, a total of 4,814 subjects aged 45–75 years were included in the study.
From the year 2000 to 2003, a total of 4,814 subjects aged 45–75 years were included in the study. In 30 of these subjects (0.6%), determination of ABI was not possible because of disorders of the leg (edema, pain, ulcers, amputation) or of the arm (lymphedema in a case of mammary carcinoma), leaving 4,735 subjects (99.4%) in the data set who served as the study group for all analyses presented in this paper (Table 1).

kroeger_2006-EurJetEpid-Tab2The overall prevalence of PAD according to the ABI criteria was 6.4% among men and 5.1% among women. After accounting for history of PAD, the prevalence increased to 8.2% among men and 5.5% among women (Table 2).

kroeger_2006-EurJetEpid-Tab3-4Subjects with a history of coronary artery disease had a considerably higher prevalence of PAD than subjects without such a history (Table 3). Due to the differences in distribution of age in these groups, crude estimates of prevalence were confounded by age. The difference in prevalence between subjects with and without CAD became smaller but did not disappear after age-standardization.
Chronic CLI was found only in five older subjects: four men aged 51–72 years (median: 66.5 years) and one woman aged 74 years. Thus, 0.1% of the study population and 2% of the subjects with PAD had CLI.
With use of the criterion of ABI >1.3, about 13.3% of males and 6.9% of females had MC (Table 4). This prevalence is much higher than that of PAD, especially for males. In contrast to PAD, there appears to be a constant percentage of subjects in each age group, which is higher for males than for females. With the criterion of ABI >1.5, only 1.1% and 0.5% of males and females, respectively, had MC. With MC defined by absolute cuff pressure, 30 (0.6%) subjects had MC with incompressible arteries at pressures 260 mmHg and higher (weiter…)