Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: A longitudinal study

The current study describes the age- and sex-specific incidence rates and r isk factors for asymptomatic and symptomatic peripheral arterial occlusive disease (PAOD) among 2,327 subjects and the incidence of intermittent claud ication in asymptomatic PAOD subjects. The study population was selected fr om 18 general practice centers in the Netherlands. PAOD was assessed with t he ankle-brachial blood pressure index, and intermittent claudication was a ssessed with a modified version of the Rose questionnaire. After 7.2 years, the overall incidence rate for asymptomatic PAOD, using the person-years m ethod, was 9.9 (95% confidence interval (CI): 7.3, 18.8) per 1,000 person-y ears at risk. The rate was 7.8 (95% CI: 4.9, 20.3) for men and 12.4 (95% CI : 7.7, 24.8) for women. For symptomatic PAOD, the incidence rate was 1.0 (9 5% CI: 0,7, 7.5) overall, 0.4 (95% CI: 0.3, 10.0) for men, and 1.8 (95% CI: 1.0, 10.3) for women. Multivariate analyses showed that increasing age, sm oking, hypertension, and diabetes mellitus were the most important risk fac tors. The overall incidence rate for intermittent claudication among PAOD s ubjects who were asymptomatic at baseline was 90.5 per 1,000 person-years a t risk (95% CI: 36.4, 378.3). The incidence of asymptomatic PAOD was higher than the incidence of symptomatic PAOD, with women developing PAOD more of ten than men. In the development of preventive strategies, modification of atherosclerotic risk factors, such as smoking, hypertension, and diabetes, should be the main goals.