Peripheral arterial disease prevalence

Ness J, Aronow WS. Prevalence of coexistence of coronary artery disease, ischemic stroke, and peripheral arterial disease in older persons, mean age 80 years, in an academic hospital-based geriatrics practice. J Am Geriatr Soc 1999 47 1255-1256. 

The prevalence of peripheral arterial disease is dependent upon age and the presence of traditional risk factors for cardiovascular disease and many patients are undiagnosed undiagnosed patients have substantial risk for coronary and cerebrovascular events. 

Selvin E, TP E. Prevalence of and risk factors for peripheral arterial disease in the United States. Results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation 2004 110 738-743. 

Pomrehn P, Duncan B, Weissfeld L, Wallace RB, Barnes R, Heiss G, et al. The associationof dyslipoproteinemias with symptoms and signs of peripheral arterial disease. The Lipid Research Clinics Program Prevalence Study. Circulation 1986 73 1100-1107. 

Fowkes FG, Housley E, Cawood EH, Macintyre CC, Ruckley CV, Prescott RJ. Edinburgh Artery Study Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol 1991 20 384-392. 

This chapter will review the available studies that report the incidence and prevalence of peripheral vascular disease in both type 1 and type 2 diabetic patients. It will focus not only on risk factors associated with the development of peripheral arterial disease, but also touch on pathophysiologic changes that may help to account for some epidemiologic trends. Lastly, it will highlight differences between diabetic and nondiabetic subjects concerning localization of disease and its association with mortality and limb loss. 

Note in most studies, diabetes itself is associated with a much higher prevalance of peripheral artery disease compared to nondiabetic populations. 

Novo S, Avellon G, Di Garbo V, et al. Prevalence of risk factors in patients with peripheral arterial disease. A clinical and epidemiological evaluation. Int Angiol 1992 11 218-229. 

Criqui MH, Fronek A, Barrett-Coimor E, et al. The prevalence of peripheral arterial disease in a defined population. Circulation 1985 71 510-515. 

Naidu SS, Vlachos HA, Faxon D, et al. Vascular disease independently predicts worse outcome after percutaneous coronary intervention Results from the NHLBI Dynamic Registry. JAm Coll Cardiol 2003 41 6 3A abstract 1005A-211. Aronow WS, Ahn C. Prevalence of coexistence of coronary artery disease, peripheral arterial disease, and atherothrombotic brain infarction in men and women 62 > years of age. Am J Cardiol 1994 74 64-65. 

Tools to improve cardiovascular health are of great importance in countries where life expectancy is significantly increasing and where the prevalence of lifestyle-related diseases such as cardiovascular disease and type II diabetes is constantly growing. Atherosclerosis is still the leading cause of mortality and morbidity in affluent societies. By changing diet and lifestyle the risk factors for cardiovascular mortality and morbidity can be lowered. Among these risk factors, the importance of total cholesterol and low-density lipoprotein (LDL) cholesterol levels in blood semm is well established. An elevated serum concentration of cholesterol and especially of LDL cholesterol is a key risk factor for the development of atherosclerosis and its clinical manifestations, which include coronary heart disease and cerebrovascular and peripheral artery diseases. 

As the prevalence of obesity increases worldwide, so does the prevalence of associated co-morbidities type-2 diabetes, chronic obstructive sleep apnoea, cardiovascular disease (hyper-tension, coronary artery disease and congestive heart failure, stroke and peripheral vascular disease), fatty liver disease, various malignancies (Table 7.2), gallstones, subfertility, musculo-skeletal problems and depression. 

Brevetti G, Piscione p Silvestro A, et al, Increased inflammatory status and higher prevalence of three-vessel coronary artery disease in patients with concomitant coronary and peripheral atherosclerosis, Thromb Haemost 2003 89 1058-1063,... 

The incidence of type 2 (noninsulin-dependent) diabetes mellitus continues to increase in the United States (1). Consequently, the associated morbid and mortal events from the associated microvascular and macrovascular complications of this disease have also risen (1). The preponderance of research toward the understanding of vascular disease in diabetes has been directed toward the delineation of end organ injury from microvascular disease. Consequently, the focus on macrovascular peripheral vascular disease has been relatively ignored. However, several studies have elucidated both the incidence and prevalence of peripheral vascular disease associated with both type 1 (insulin-dependent) and type 2 diabetes mellitus. In general, these studies have found that the duration of diabetes is perhaps the best correlate to predict the development of coronary artery and renal disease, as well as other associated end organ injuries that have not consistently correlated with the development of peripheral vascular disease. 

Malinow MR, Kang SS, Taylor LM, Wong PW, Couil B, Inahara T, et al. Prevalence of hyperhomocysteinemia in patients with peripheral arterial occlusive disease. Circulation 1989 79 1180-1188. 

HDL is another one of the major lipoproteins in circulation known as the good lipoprotein due to the fact that HDL transports cholesterol and fat molecules from peripheral tissues and arterial walls to the liver for excretion. Enhanced plasma HDL-cholesterol concentration lowers the risk of cardiovascular-associated diseases [41] providing healthy endothelial cell function (vasodilation) [42]. HDL enhances the activity of endothelial NOS to induce femoral arterial vasodilation in vitro [43] and enhances myocardial perfusion via NO-dependent mechanisms in vivo [44]. Altogether, these data suggest that HDL may reduce the prevalence and may serve as a novel biometric for cardiovascular disease. 

Cardiovascular The safety of oxytocin during cesarean section has been reviewed [55 , 56"]. Oxytocin causes peripheral vasodilatation and hypotension, leading to increases in heart rate, cardiac output, and pulmonary arterial pressure. However, animal models suggest that oxytocin differentially affects the coronary vasculature and causes vasoconstriction. Oxytocin boluses of 10 lU have been associated with maternal deaths in patients with underlying cardiac disease or pre-existing hypotension. The prevalence of hypotension after an oxytocin bolus depends on the dose and speed of... 

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