Prevalence and risk factors of peripheral vascular disease in a selected South Indian population - The Chennai urban population study

OBJECTIVE - The epidemiology of peripheral vascular disease has rarely been studied in non-European populations. The purpose of this study was to dete rmine the prevalence and risk factors of peripheral vascular disease (PVD) among South Indians. RESEARCH DESIGN AND METHODS - The Chennai Urban Population Study is an epid emiological study involving 2 residential areas in Chennai in South India. Of the 1,399 eligible subjects (greater than or equal to 20 years of age), 1,262 (90.2%) participated in the study. All of the study subjects underwen t an oral glucose tolerance test and were categorized as having normal gluc ose tolerance (NGT), impaired glucose tolerance (IGT), or diabetes. Periphe ral Doppler studies were performed on 50% of the study subjects, and PVD wa s defined as an ankle-brachial index (ABI) <0.9. RESULTS - The prevalence rates of PVD were 2.7, 2.9, and 6.3% in individual s with NGT, IGT, and diabetes, respectively. The overall prevalence rate wa s 3.2%. Known diabetic subjects had a higher prevalence of PVD (7.8%) compa red with newly diagnosed diabetic subjects (3.5%). PVD was uncommon until m iddle-age and then the prevalence rate increased dramatically. Univariate r egression analysis showed age >50 years (odds ratio [OR] 6.3, 95% CI 2.1-20 .6, P < 0001) and hypertension (OR 2.7, 0.9-7.3, P = 0.08) to be associated with PVD, whereas smoking and serum lipid levels showed no association. Mu ltivariate regression analysis identified age at the most significant risk factor for PVD. Of the 90 subjects who had coronary artery disease (CAD), o nly 6 had PVD, and the positive predictive value of the ABI for CAD was onl y 30%. CONCLUSIONS - The prevalence of PVD in this urban South Indian population i s considerably lower than that reported in European and U.S. studies and is in marked contrast to the high prevalence rate of CAD reported in this pop ulation.