Predictive power of cardiovascular risk factors for detecting peripheral vascular disease.

Abstract:

OBJECTIVES:Peripheral vascular disease (PVD) is underdiagnosed in primary care due to the absence of established criteria to warrant diagnostic testing. Our goal was to establish a risk factor hierarchy to enable earlier diagnosis of PVD. METHODS:Data sets of 142 patients with abnormal ankle brachial indices (ABI) were randomly selected from our patient database to determine the prevalence of specific cardiovascular risk factors and demographic data. An ABI score < 0.90 is diagnostic of PVD. Patients were stratified into mild (0.75-0.89), moderate (0.50-0.74), and severe disease (< 0.50). RESULTS:Mean age was 69 +/- 9.9, ABI 0.65 +/- 0.16. Risk factor prevalence: diabetes, 42%; hypertension, 87%; tobacco use, 34%; hyperlipidemia, 53%; obesity, 24%; cardiovascular disease (CVD), 69%; stroke, 15%. Total risk factors per patient v = 3.2 +/- 1.3. Disease severity stratifications: mild, n = 46 (age v = 68.6 +/- 10.4, ABI v = 0.82 +/- 0.05); moderate, n = 72 (age v = 69.9 +/- 9.4, ABI v = 0.62 +/- 0.07); severe, n = 24 (age v = 67.5 +/- 10.9, ABI v = 0.40 +/- 0.06). Independent variable mean differences: hypertension-CVD (P = 0.0002); CVD-hyperlipidemia (P = 0.002); hyperlipidemia-diabetes (P = 0.0008); diabetes-tobacco use (P = 0.001); tobacco use-obesity (P = 0.0003); obesity-stroke (P = 0.05). Independent variable mean differences were significant across disease severity (P < 0.00001). CONCLUSIONS:Our study establishes the following hierarchy of cardiovascular risk factors as predictors of PVD: hypertension, cardiovascular disease, hyperlipidemia, diabetes, tobacco use, obesity, stroke.

journal_name

South Med J

journal_title

Southern medical journal

authors

Fine JJ,Hall PA,Richardson JH

doi

10.1097/01.SMJ.0000141303.47034.46

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

951-4

issue

10

eissn

0038-4348

issn

1541-8243

journal_volume

97

pub_type

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