Prevalence, correlates, and prognosis of peripheral artery disease in rural ecuador-rationale, protocol, and phase I results of a population-based survey: an atahualpa project-ancillary study

Association between lifestyles, anthropometric measurements and peripheral arterial disease in public sector health workers

Introduction: Peripheral arterial disease (PAD) occurs when there is a narrowing of the blood vessels outside the heart; this disease is concentrated in low and middle income countries such as Peru. Objectives: To determine the association between lifestyles, anthropometric measurements and PAD in health workers at the Hospital de Huaycan, 2020. Methods: Cross-sectional analytical study that recruited health workers of both sexes, who had no history of cardiovascular disease, type 2 diabetes mellitus nor were pregnant. Lifestyle was measured through a questionnaire and PAD through the ankle-brachial index <0.90 in any leg. Results: In total 184 health workers, 53 men and 131 women with an average age of 46.0 ± 10.0 years were analyzed. The prevalence of PAD was 31% in the total sample. Both the bivariate and multivariate analyses showed that an inadequate lifestyle (PRa = 1.62; 95% CI: 1.08-2.44), high waist-hip ratio (PRa = 1.90; 95% CI: 1.19-3.03) and increased body fat (PRa = 1.03; 95% CI: 1.00-1.07) present an independent and statistically significant association with PAD. Conclusion: There is an association between lifestyles, waist-hip ratio, and body fat percentage with PAD in health workers.

Consensus recommendations for essential vascular care in low- and middle-income countries

OBJECTIVE

Many low- and middle-income countries (LMICs) are ill equipped to care for the large and growing burden of vascular conditions. We aimed to develop essential vascular care recommendations that would be feasible for implementation at nearly every setting worldwide, regardless of national income.

METHODS

The normative Delphi method was used to achieve consensus on essential vascular care resources among 27 experts in multiple areas of vascular care and public health as well as with experience in LMIC health care. Five anonymous, iterative rounds of survey with controlled feedback and a statistical response were used to reach consensus on essential vascular care resources.

RESULTS

The matrices provide recommendations for 92 vascular care resources at each of the four levels of care in most LMICs, comprising primary health centers and first-level, referral, and tertiary hospitals. The recommendations include essential and desirable resources and encompass the following categories: screening, counseling, and evaluation; diagnostics; medical care; surgical care; equipment and supplies; and medications.

CONCLUSIONS

The resources recommended have the potential to improve the ability of LMIC health care systems to respond to the large and growing burden of vascular conditions. Many of these resources can be provided with thoughtful planning and organization, without significant increases in cost. However, the resources must be incorporated into a framework that includes surveillance of vascular conditions, monitoring and evaluation of vascular capacity and care, a well functioning prehospital and interhospital transport system, and vascular training for existing and future health care providers.