THE PREVALENCE OF ASYMPTOMATIC AND UNRECOGNIZED PERIPHERAL ARTERIAL OCCLUSIVE DISEASE

Background. The prevalence of peripheral arterial occlusive disease (P AOD), including asymptomatic cases and cases unknown to the general pr actitioner (GP) was estimated in 18 884 men and women, aged 45-74 year s, on the list of 18 general practice centres (GPC). Methods. The stud y population (n = 3171) consisted of a stratified sample of the total population. In the GPC data were collected on intermittent claudicatio n (IC), peripheral pulses, vascular risk factors, cardio- and cerebrov ascular disease (CCVD) and the ankle brachial systolic pressure ratio (AB ratio) and PAOD was defined as an AB ratio <0.95 on two consecutiv e occasions. Results were recalculated for the total population. Resul ts. The prevalence of PAOD was 6.9% (95% confidence interval [CI] : 5. 7-8.2%), of which one-third (2.2%) had an AB ratio <0.75. The prevalen ce of IC was 6.6% (95% CI : 5.2-7.9%), a quarter of which (1.6%) met t he classic WHO criteria. Peripheral arterial occlusive disease did not occur significantly more often among men than among women but men suf fered more often from an advanced stage of PAOD. Of ail PAOD cases, 22 % were symptomatic. The proportion of symptomatic cases correlated pos itively with higher age, male gender and lower AB ratio. Among asympto matic PAOD cases the prevalence of concomitant CCVD was three to four times as high as in the group of subjects without PAOD. Of all PAOD ca ses 68% were unknown to the GP and this group mainly represented less advanced cases of atherosclerosis. However, among PAOD cases with an A B ratio <0.75, 42% were unknown to the GP. Conclusions. Our data on as ymptomatic and unknown PAOD cases show that GPs can still enhance thei r efforts towards (secondary) prevention of atherosclerosis.