HYPERTENSION AND OTHER RISK-FACTORS IN PERIPHERAL ARTERIAL-DISEASE

Aim of this study has been to evaluate the prevalence of arterial hype rtension and other risk factors in patients suffering with PAD in two clinical samples (l.: 102 patients with PAD, 69 M, 33 F, studied in ou r angiology laboratory, matched for sex and age with 102 healthy volun teers; 2.: 184 hospitalized patients, 80 M, 104 F, mean age 57.2+/-10. 8, with PAD) and in two epidemiological studies (l.: Trabia Study, 835 subjects; and 2.: Casteldaccia Study, 723 subjects). All patients per formed a full clinical and laboratory examination, including the deter mination of the ankle/arm pressure ratio (Winsor index, positive for P AD when lower than 0.95). In the first clinical study we observed a si gnificantly (p<0.01) greater prevalence of arterial hypertension (51.9 vs 9.8%), hypercholesterolemia ( 48.2 vs 21.6%), hypertriglyceridemia (53.7 vs 26.1%), smoking habit (64.3 vs 44.2%), and hyperglycemia (26 vs 7.9%) in PAD patients than in controls. In the second clinical stu dy, considering separately the patients under and over 65 years, all r isk factors resulted more prevalent in younger people than in the aged , except diabetes and hypertension. In our epidemiological experience, the prevalence of PAD increases with aging, above all in males. In th e Trabia study the risk factors more associated with PAD have been hyp ercholesterolemia, smoking and obesity (41.18%) in males and hypertens ion and hypercholesterolemia (33.3%) and obesity (25%) in females. In the Casteldaccia Study the most important risk factors have been smoki ng habit (64.28%), hypercholesterolemia ( 42.86%) and hypertriglycerid emia (35.71%) in males, and obesity (60%), hypercholesterolemia (30%) and diabetes (20%) in females. Cholesterol levels and smoking habit ha ve been significantly higher in PAD patients than in general populatio n, whereas hypertriglyceridemia and glycemia did not. Arterial hyperte nsion has been significantly associated with PAD in the Trabia Study, but not in the Casteldaccia one. Obesity has been significantly associ ated to PAD in females in both study. In the Casteldaccia Study, lower HDL-cholesterol levels have been observed in PAD patients, above all males, whereas significantly greater Apo-B values and lower Apo-Al lev els (in males) have been shown. The different levels of associated ris k factors and their prevalence in PAD patients confirm the multifactor ial pathogenesis of atherosclerosis. The exact role of each risk facto r in the genesis of PAD is difficult to evaluate due to the complex bi ological and statistical interrelationships among different risk facto rs. However, the management of associated risk factors may favourably influence the risk profile in each patient suffering with PAD.