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Porras CP, de Boer AR, Koop Y, Vaartjes I, Teraa M, Hazenberg CEVB, Verhaar MC, Vernooij RWM. Sex Differences in Mortality Risk after the First Hospitalisation with Lower Extremity Peripheral Arterial Disease. Eur J Vasc Endovasc Surg 2024:S1078-5884(24)00375-7. [PMID: 38697256 DOI: 10.1016/j.ejvs.2024.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 03/22/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE Lower extremity peripheral arterial disease (PAD) is a severe condition that increases the risk of major adverse cardiovascular events, major adverse limb events, and all cause mortality. This study aimed to investigate the mortality risk among females and males hospitalised for the first time with lower extremity PAD. METHODS Three cohorts of patients who were admitted for the first time with lower extremity PAD in 2007 - 2010, 2011 - 2014, and 2015 - 2018 were constructed. For the 2007 - 2010 and 2011 - 2014 cohorts, the 28 day, one year, and five year mortality rates were calculated, assessing survival time from date of hospital admission until date of death, end of study period, or censoring. For the 2015 - 2018 cohort, only 28 day and one year mortality were investigated due to lack of follow up data. Mortality rates of these cohorts were compared with the general population using standardised mortality rates (SMRs), and the risk of death between sexes was evaluated using Cox proportional hazards models. Cox models were adjusted for age, cardiovascular disease, and diabetes mellitus to account for potential confounding factors. RESULTS In total, 7 950, 9 670, and 13 522 patients were included in the 2007 - 2010, 2011 - 2014, and 2015 - 2018 cohorts, respectively. Over 60% of individuals in each cohort were males. Mortality rates at 28 day and one year remained stable across all cohorts, while the five year mortality rate increased for both males and females in the 2011 - 2014 cohort. The SMRs both of females and males with PAD were significantly higher than in the general population. Multivariable regression analyses found no significant differences in mortality risk between sexes at 28 day and one year. However, the five year mortality risk was lower in females, with a hazard ratio of 0.89 (95% confidence interval [CI] 0.83 - 0.97) in the 2007 - 2010 cohort and 0.88 (95% CI 0.82 - 0.94) in the 2011 - 2014 cohort. CONCLUSION The five year mortality risk has increased, and females face a lower mortality risk than males. Lower extremity PAD still carries unfavourable long term consequences compared with the general population.
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Affiliation(s)
- Cindy P Porras
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Annemarijn R de Boer
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Yvonne Koop
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Ilonca Vaartjes
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Martin Teraa
- Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Marianne C Verhaar
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Robin W M Vernooij
- Department of Nephrology and Hypertension, University Medical Centre Utrecht, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
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Herráiz-Adillo Á, Soriano-Cano A, Martínez-Hortelano JA, Garrido-Miguel M, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, Notario-Pacheco B. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study. Blood Press 2017; 27:112-119. [DOI: 10.1080/08037051.2017.1400903] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Alba Soriano-Cano
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | | | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Herráiz-Adillo Á, Martínez-Vizcaíno V, Cavero-Redondo I, Álvarez-Bueno C, Garrido-Miguel M, Notario-Pacheco B. Diagnostic Accuracy Study of an Oscillometric Ankle-Brachial Index in Peripheral Arterial Disease: The Influence of Oscillometric Errors and Calcified Legs. PLoS One 2016; 11:e0167408. [PMID: 27898734 PMCID: PMC5127576 DOI: 10.1371/journal.pone.0167408] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/14/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Peripheral arterial disease (PAD) is an indicator of widespread atherosclerosis. However, most individuals with PAD, in spite of being at high cardiovascular risk, are asymptomatic. This fact, together with the limitations of the Doppler ankle-brachial index (ABI), contributes to PAD underdiagnose. The aim of this study was to compare oscillometric ABI and Doppler ABI to diagnose peripheral arterial disease, and also to examine the influence of oscillometric errors and calcified legs on the PAD diagnoses. METHODS AND FINDINGS We measured the ankle-brachial indexes of 90 volunteers (n = 180 legs, age 70 ± 14 years, 43% diabetics) using both oscillometer OMRON-M3 and Doppler. For concordance analyses we used the Bland and Altman method, and also estimated the intraclass correlation coefficient. Receiver Operating Characteristic Curves were used to examine the diagnostic performance of both methods. The ABI means were 1.06 ± 0.14 and 1.04 ± 0.16 (p = 0.034) measured by oscillometer and Doppler ABIs respectively, with limits of agreement of ± 0.20 and intraclass correlation coefficient = 0.769. Oscillometer yielded 23 "error" measurements, and also overestimated the measurements in low ankle pressures. Using Doppler as gold standard, oscillometer performance for diagnosis of PAD showed an Area Under Curve = 0.944 (sensitivity: 66.7%, specificity: 96.8%). Moreover, when considered calcified legs and oscillometric "error" readings as arteriopathy equivalents, sensitivity rose to 78.2%, maintaining specificity in 96%. The best oscillometer cut-off point was 0.96 (sensitivity: 87%, specificity: 91%, positive likelihood ratio: 9.66 and negative likelihood ratio: 0.14). CONCLUSION Despite its limitations, oscillometric ABI could be a useful tool for the diagnosis of PAD, particularly when considering calcified legs and oscillometric "errors" readings as peripheral arterial disease equivalents.
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Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Cuenca, Spain
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
- * E-mail:
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha. Health and Social Research Center. Cuenca, Spain
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Oriol Torón PÁ, Badía Farré T, Romaguera Lliso A, Roda Diestro J. Metabolic syndrome and peripheral artery disease: Two related conditions. ACTA ACUST UNITED AC 2016; 63:258-64. [PMID: 27165186 DOI: 10.1016/j.endonu.2016.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 03/01/2016] [Accepted: 03/13/2016] [Indexed: 12/26/2022]
Abstract
AIMS To ascertain the prevalence of metabolic syndrome (MS) in patients with peripheral artery disease (PAD) at the Martorell primary care (PC) center. To analyze the differences in comorbidities and cardiovascular risk factors between patients with PAD with and without MS. METHODS A cross-sectional, descriptive study on patients diagnosed with PAD according to computerized clinical records of the Martorell PC center. Variables collected included age, sex, high blood pressure (HBP), dyslipidemia (DLP), diabetes (DM), smoking, obesity, cardiovascular disease (CVD), erectile dysfunction (ED), renal failure (RF), and oligoalbuminuria. An analysis comparing patients with and without MS was performed. RESULTS There were 131 patients diagnosed with PAD, 104 (79%) of whom were male. Sixty-three (48.1%) also had MS. Patients with both PAD and MS had, as compared to those with PAD only, a higher prevalence of HBP (87.3 vs. 60.3%, P: 0.001), DLP (77.8 vs. 60.3%, P: 0.03), DM (69.8 vs. 30.9%, P<.001), obesity (25.4 vs. 10.3%, P: 0.03), CVD (42.9 vs. 19.1%); P: 0.004), ED (81.3 vs. 54.3%, P: 0.02), and RF (40.3 vs. 17.9%, P: 0.006). CONCLUSION Patients with both PAD and MS had a higher prevalence of HBP, DLP, DM, and obesity. They also had more cardiovascular events and were significantly associated with pathological conditions highly relevant for cardiovascular prognosis such as erectile dysfunction and chronic kidney disease.
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Affiliation(s)
| | | | - Amparo Romaguera Lliso
- Departament de Metodología, Qualitat i Avaluació Assistencial, AP Costa de Ponent, Institut Catalá de la Salut, Barcelona, España
| | - Jovita Roda Diestro
- Diplomada Universitaria en Enfermería, ABS Sant Andreu de la Barça, Barcelona, España
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Diagnóstico precoz de la arteriopatía periférica mediante la determinación automática del índice tobillo-brazo. Med Clin (Barc) 2014; 143:352-3. [DOI: 10.1016/j.medcli.2014.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 01/09/2014] [Indexed: 11/24/2022]
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Forés R, Alzamora MT, Pera G, Torán P, Urrea M, Heras A. [Concordance between 3 methods of measurement the ankle-brachial index to diagnose peripheral artery disease]. Med Clin (Barc) 2014; 143:335-40. [PMID: 24703416 DOI: 10.1016/j.medcli.2013.10.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/27/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES To determine the concordance of the ankle-brachial index (ABI) determined by automatic measurements (sphygmomanometer Omron and the triple cuff device) using doppler as the gold-standard, computing as well as sensitivity and specificity. PATIENTS AND METHODS ARTPER population cohort subjects, classified as peripheral arterial disease (PAD) if ABI<0.9, calcified if ABI≥1.4 and healthy otherwise. To asses concordance we used kappa index using the 3 categories and the intraclass correlation coefficient (ICC) for ABI continuous values. RESULTS Eighty-eight participants, 52% women, 57-87 years. It was possible to calculate the ABI using doppler for 100%, 97% using Omron and 95% using triple. ABI means (standard deviation) were: doppler 1.089 (0.236), Omron 1.082 (0.110), triple 1.146 (0.134), with poor agreement (ICC doppler/Omron=0.27, doppler/triple=0.13, and triple/Omron=0.39). Categorizing ABI as PAD-healthy-calcified 13.6% (doppler), 6.8% (Omron) and 3.4% (triple) were PAD and 9.1% (doppler), 1.1% (Omron) and 9.1% (triple) were calcified. Kappa indexes were weak (doppler/Omron=0.22, doppler/triple=0.01, triple/Omron=0.17). Both triple and Omron were highly specific (97%) but had very low sensitivity (8 and 33%, respectively) compared to doppler. CONCLUSIONS Concordance of ABI automatic measurements as Omron and triple with doppler was poor, and they do not seem suitable for screening for PAD in primary care consultations.
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Affiliation(s)
- Rosa Forés
- Centre d'Atenció Primària Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España.
| | - Maria Teresa Alzamora
- Centre d'Atenció Primària Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España
| | - Guillem Pera
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España
| | - Pere Torán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España
| | - Magalí Urrea
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España
| | - Antonio Heras
- Centre d'Atenció Primària Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Barcelona, España; Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Santa Coloma de Gramenet, Barcelona, España
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Rodriguez-Roca GC, Villarín-Castro A, Carrasco-Flores J, Artigao-Rodenas LM, Carbayo-Herencia JA, Escobar-Cervantes C, Alonso-Moreno FJ, Segura-Fragoso A, Gómez-Serranillos M, Hernández-Moreno J. Concordance between automated oscillometric measurement of ankle-brachial index and traditional measurement by eco-Doppler in patients without peripheral artery disease. Blood Press 2014; 23:270-5. [PMID: 24646328 DOI: 10.3109/08037051.2013.876796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To evaluate the concordance between automated oscillometric measurement (WatchBP® Office ABI) of the ankle- brachial index (ABI) and the traditional measurement by eco-Doppler in a Spanish population without peripheral artery disease attended in primary care. METHODS The ABI was determined by both methods in a general population aged ≥ 18 years, from the RICARTO study. The intraclass correlation coefficient was calculated to assess the concordance between both techniques and the Bland-Altman plot was determined to analyze the agreement between them. RESULTS A total of 322 subjects (mean age 47.7 ± 16.0 years; 54.3% women) were included in the study. With regard to cardiovascular risk factors, 70.5% of subjects had dyslipidemia, 26.7% hypertension, 24.8% obesity, 8.4% diabetes and 25.5% were smokers. Mean ABI measured by eco-Doppler and the automated method were 1.17 ± 0.1 and 1.2 ± 0.1, respectively (mean differences - 0.03 ± 0.09; p < 0.001). The Pearson correlation coefficient and the intraclass correlation coefficient were in both cases 0.70. CONCLUSIONS The automated oscillometric measurement of ABI is a reliable and useful alternative to conventional eco-Doppler determination in the general population without peripheral artery disease attended in primary care.
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Alzamora MT, Forés R, Pera G, Torán P, Heras A, Sorribes M, Baena-Diez JM, Urrea M, Alegre J, Viozquez M, Vela C. Ankle-brachial index and the incidence of cardiovascular events in the Mediterranean low cardiovascular risk population ARTPER cohort. BMC Cardiovasc Disord 2013; 13:119. [PMID: 24341531 PMCID: PMC3878485 DOI: 10.1186/1471-2261-13-119] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 12/10/2013] [Indexed: 11/10/2022] Open
Abstract
Background Peripheral arterial disease (PAD) of the lower limbs is a cardiovascular disease highly prevalent particularly in the asymptomatic form. Its prevalence starts to be a concern in low coronary risk countries like Spain. Few studies have analyzed the relationship between ankle-brachial index (ABI) and cardiovascular morbi-mortality in low cardiovascular risk countries like Spain where we observe significant low incidence of ischemic heart diseases together with high prevalence of cardiovascular risk factors. The objective of this study is to determine the relationship between pathological ABI and incidence of cardiovascular events (coronary disease, cerebrovascular disease, symptomatic aneurism of abdominal aorta, vascular surgery) and death in the >49 year population-based cohort in Spain (ARTPER). Methods Baseline ABI was measured in 3,786 randomly selected patients from 28 Primary Health Centers in Barcelona, distributed as: ABI<0.9 peripheral arterial disease (PAD), ABI ≥1.4 arterial calcification (AC), ABI 0.9-1.4 healthy; and followed during 4 years. Results 3,307 subjects were included after excluding those with previous vascular events. Subjects with abnormal ABI were older with higher proportion of men, smokers and diabetics. 260 people presented cardiovascular events (incidence 2,117/100,000 person-years) and 124 died from any cause (incidence 978/100,000 person-years). PAD had two-fold greater risk of coronary disease (adjusted hazard ratio (HR) = 2.0, 95% confidence interval (CI) 1.3-3.2) and increased risk of vascular surgery (HR = 5.6, 95%CI 2.8-11.5) and mortality (HR = 1.8, 95%CI 1.4-2.5). AC increased twice risk of cerebrovascular events (HR = 1.9, 95%CI 1.0-3.5) with no relationship with ischemic heart disease. Conclusions PAD increases coronary disease risk and AC cerebrovascular disease risk in low cardiovascular risk Mediterranean population. ABI could be a useful tool to detect patients at risk in Primary Health Care.
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Affiliation(s)
- Maria Teresa Alzamora
- Primary Healthcare Centre Riu Nord-Riu Sud, Institut Català de la Salut, Santa Coloma de Gramenet, Spain.
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Infradiagnóstico de enfermedad arterial periférica en pacientes con diabetes mellitus atendidos en consultas de segundo nivel. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.avdiab.2013.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Bundó M, Urrea M, Muñoz L, Llussà J, Forés R, Torán P. Correlación entre los índices dedo-brazo y tobillo-brazo en pacientes con diabetes mellitus tipo 2. Med Clin (Barc) 2013; 140:390-4. [DOI: 10.1016/j.medcli.2012.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/26/2012] [Accepted: 03/01/2012] [Indexed: 11/29/2022]
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Morales-Gisbert SM, Plaza-Martínez Á, Sala-Almonacil VA, Olmos-Sánchez D, Gomez-Palonés FJ, Ortiz-Monzón E. [Natural history of moderate-degree carotid stenosis in patients with peripheral artery disease]. Med Clin (Barc) 2013; 140:337-42. [PMID: 23339889 DOI: 10.1016/j.medcli.2012.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 06/06/2012] [Accepted: 06/07/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE To understand the evolution of moderate asymptomatic carotid stenosis, the factors that influence its progression and the related morbimortality. PATIENTS AND METHODS Retrospective observational study of 133 patients with asymptomatic carotid stenosis between 50-69% in one or both carotids between 2002 and 2009. Included patients were subjected to screening for peripheral arterial disease (PAD), aneurysmal disease or carotid bruit. The monitoring was carried out using an annual duplex scan. The rate of progression, the variables related to this, the appearance of neurological events, and global and cardiovascular mortality were evaluated. Descriptive studies, univariate analysis (chi-squared test and Student's t-test), multivariate analysis (logistic regression), and survival curves (Log-Rank test) were carried out. RESULTS With an average time of monitoring: 30.8 ± 1.7 months, stenosis progression was observed in 33% of the patients, with an average progression time of 31.3 ± 2.7 months. Greater progression was observed in the subgroup of patients with PAD and ischemic heart disease (odds ratio [OR] 2.84, confidence interval [CI] 95% 1.14-7.03). In the multivariate analysis only the PAD was identified as a risk factor for progression (P=.043). The group of patients with progression showed greater rates of neurological events: 15 vs. 1.6% (P=.01), greater global mortality: 15 vs. 3% (P=.04), and greater cardiovascular mortality: 12.1 vs. 1.5% (P=.03). CONCLUSIONS The progression of asymptomatic carotid stenosis between 50-69% is common in patients subjected to screening, especially in those with a history of ischaemic heart disease and/or PAD. This progression is associated with an increased rate of cardiovascular complications. For this reason, we recommend clinical and echographic follow-up of these patients.
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Inglis SC, Lewsey JD, Lowe GDO, Jhund P, Gillies M, Stewart S, Capewell S, Macintyre K, McMurray JJV. Angina and intermittent claudication in 7403 participants of the 2003 Scottish Health Survey: impact on general and mental health, quality of life and five-year mortality. Int J Cardiol 2012; 167:2149-55. [PMID: 22704868 DOI: 10.1016/j.ijcard.2012.05.099] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 05/18/2012] [Accepted: 05/27/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Angina and intermittent claudication impair function and mobility and reduce health-related quality of life. Both symptoms have similar etiology, yet the physical and psychological impacts of these symptoms are rarely studied in community-based cohorts or in individuals with isolated symptoms. METHODS The 2003 Scottish Health Survey was a cross-sectional survey which enrolled a random sample of individuals aged 16-95 years living in Scotland. The Rose Angina Questionnaire, the Edinburgh Claudication Questionnaire, the Short Form-12 (SF-12) and the General Health Questionnaire were completed. Self-assessed general health was reported. Survey results were linked to national death records and mortality at five years was calculated. Subjects with isolated angina or intermittent claudication and neither symptom were compared (22 participants with both symptoms were excluded); 7403 participants (aged ≥ 16 years) were included. RESULTS Participants with angina (n=205; 60 ± 15 years; 45% male) rated their general health worse and were more likely to have a potential mental-health problem than those with intermittent claudication (n=173; 61 ± 15 years; 41% male). Mean (standard deviation) physical and mental component scores on the SF-12 were higher for participants with intermittent claudication relative to those with angina (physical component score: 42.3 (10.6) vs. 35.0 (11.7), p<0.001; mental component score: 52.3 (8.5) vs. 46.5 (11.7), p=0.001). There was an observed absolute difference in five-year mortality of 4.8% (angina 12.3%, 95% CI 8.5-17.6; intermittent claudication 7.5%, 95% CI 4.4-12.6) although not statistically significant (p=0.16). CONCLUSIONS Both intermittent claudication and angina adversely impact general and mental health and survival, even in a relatively young, community-based cohort.
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Affiliation(s)
- Sally C Inglis
- BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.
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Relevancia de la enfermedad arterial periférica en sujetos de edad avanzada. HIPERTENSION Y RIESGO VASCULAR 2012. [DOI: 10.1016/j.hipert.2011.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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¿A quién medir el índice tobillo-brazo? Med Clin (Barc) 2011; 137:282. [DOI: 10.1016/j.medcli.2010.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 10/06/2010] [Accepted: 10/07/2010] [Indexed: 11/20/2022]
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Mostaza JM, Lahoz C. ¿A quién medir el índice tobillo-brazo? Med Clin (Barc) 2010; 135:312-3. [DOI: 10.1016/j.medcli.2010.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 03/16/2010] [Accepted: 03/16/2010] [Indexed: 11/26/2022]
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