© 1991 Oxford University Press
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Edinburgh Artery Study: Prevalence of Asymptomatic and Symptomatic Peripheral Arterial Disease in the General Population
*Wolfson Unit for Prevention of Peripheral Vascular Diseases Teviot Place, Edinburgh EH8 9AG, UK.
Medical Statistics Unit, Department of Community Medicine, University of Edinburgh Teviot Place, Edinburgh EH8 9AG, UK.
Intermittent claudication has been studied in cardiovascular surveys but limited information is available on asymptomatic peripheral arterial disease. The purpose of this paper is to describe the prevalence of both asymptomatic and symptomatic disease and relation to ischaemic heart disease in the Edinburgh Artery Study. A cross-sectional survey was conducted on an age-stratified sample of men and women aged 55 to 74 years selected from age-sex registers in ten general practices in the city. Arterial disease was assessed in 1592 participants by means of the WHO questionnaire on intermittent claudication and measurement of the ankle brachial systolic pressure index (ABPI) and change in ankle systolic pressure during reactive hyperaemla. The prevalence of intermittent claudication was 4.5% (95% confidence interval (CI): 3.5%–5.5%). Major asymptomatic disease causing a significant impairment of blood flow occurred in 8.0% (95% CI: 6.6%–9.4%). A further 16.6% (95% Cl: 14.6%–18.5%) had criteria considered abnormal in clinical practice: 9.0% had ABPI <0.9 and 7.6% had reactive hyperaemia pressure reduction >20%.
Intermittent claudication was equally common in both sexes. The ABPI and reactive hyperaemia results suggested a slight preponderance of asymptomatic disease in males and were consistent with an increasing prevalence with age and lower social class. Mean ABPI was higher in normal men than women, and was lower in the left leg than the right suggesting a unilateral predisposition to disease. Subjects with major asymptomatic disease had more evidence of ischaemic heart disease than in the normal population (relative risk (RR) 1.6; 95% CI: 1.3–1.9). In conclusion, major esymptomatic atherosclerosis affecting the lower limbs occurs commonly in the general population and is associated with ischaemic heart disease such that further study is required of natural history and prospects for prevention of major vascular events.
Revised 1 November 1990
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P. Perrone-Filardi and M. Chiariello Coronary artery disease and intermittent claudication: how to manage the patient Eur. Heart J. Suppl., March 1, 2002; 4(suppl_B): B58 - B62. [Abstract] [PDF]
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R. Vliegenthart, J. M. Geleijnse, A. Hofman, W. T. Meijer, F. J. A. van Rooij, D. E. Grobbee, and J. C. M. Witteman Alcohol Consumption and Risk of Peripheral Arterial Disease : The Rotterdam Study Am. J. Epidemiol., February 15, 2002; 155(4): 332 - 338. [Abstract] [Full Text] [PDF]
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H. Gaylis, L. S. Geiss, E. Gregg, M. M. Engelgau, R. P. Ram, M. S. Eberhardt, V. L. Burt, J. H. Merenstein, M. Jimbo, R. E. Fried, et al. Diagnosis and Treatment of Peripheral Arterial Disease JAMA, January 16, 2002; 287(3): 313 - 316. [Full Text] [PDF]
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 Managing peripheral arterial disease in primary care DTB, January 1, 2002; 40(1): 5 - 8. [Abstract] [Full Text] [PDF]
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A. T. Hirsch, M. H. Criqui, D. Treat-Jacobson, J. G. Regensteiner, M. A. Creager, J. W. Olin, S. H. Krook, D. B. Hunninghake, A. J. Comerota, M. E. Walsh, et al. Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary Care JAMA, September 19, 2001; 286(11): 1317 - 1324. [Abstract] [Full Text] [PDF]
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E. B. Jude, S. O. Oyibo, N. Chalmers, and A. J.M. Boulton Peripheral Arterial Disease in Diabetic and Nondiabetic Patients: A comparison of severity and outcome Diabetes Care, August 1, 2001; 24(8): 1433 - 1437. [Abstract] [Full Text] [PDF]
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K. Klipstein-Grobusch, J. H. den Breeijen, D. E. Grobbee, H. Boeing, A. Hofman, and J. C. M. Witteman Dietary Antioxidants and Peripheral Arterial Disease : The Rotterdam Study Am. J. Epidemiol., July 15, 2001; 154(2): 145 - 149. [Abstract] [Full Text] [PDF]
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 W. R. Hiatt Medical Treatment of Peripheral Arterial Disease and Claudication N. Engl. J. Med., May 24, 2001; 344(21): 1608 - 1621. [Full Text] [PDF]
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W. M Zachry, M. D Shepherd, and J. P Wilson Inpatient utilization of medical services associated with peripheral arterial disease-related inpatient procedures in the Department of Defense Vascular Medicine, May 1, 2001; 6(2): 71 - 76. [Abstract] [PDF]
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J. D. Hooi, A. D. M. Kester, H. E. J. H. Stoffers, M. M. Overdijk, J. W. van Ree, and J. A. Knottnerus Incidence of and Risk Factors for Asymptomatic Peripheral Arterial Occlusive Disease: A Longitudinal Study Am. J. Epidemiol., April 1, 2001; 153(7): 666 - 672. [Abstract] [Full Text] [PDF]
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U. Rauch, J. I. Osende, V. Fuster, J. J. Badimon, Z. Fayad, and J. H. Chesebro Thrombus Formation on Atherosclerotic Plaques: Pathogenesis and Clinical Consequences Ann Intern Med, February 6, 2001; 134(3): 224 - 238. [Abstract] [Full Text] [PDF]
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N. M. van Popele, D. E. Grobbee, M. L. Bots, R. Asmar, J. Topouchian, R. S. Reneman, A. P. G. Hoeks, D. A. M. van der Kuip, A. Hofman, and J. C. M. Witteman Association Between Arterial Stiffness and Atherosclerosis : The Rotterdam Study Stroke, February 1, 2001; 32(2): 454 - 460. [Abstract] [Full Text] [PDF]
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W. T. Meijer, D. E. Grobbee, M. G. M. Hunink, A. Hofman, and A. W. Hoes Determinants of Peripheral Arterial Disease in the Elderly: The Rotterdam Study Arch Intern Med, October 23, 2000; 160(19): 2934 - 2938. [Abstract] [Full Text] [PDF]
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M. C. Whiteman, I. J. Deary, and F. G. R. Fowkes Personality and Social Predictors of Atherosclerotic Progression: Edinburgh Artery Study Psychosom Med, September 1, 2000; 62(5): 703 - 714. [Abstract] [Full Text] [PDF]
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M. Lievre, S. Morand, B. Besse, J.-N. Fiessinger, and J.-P. Boissel Oral Beraprost Sodium, a Prostaglandin I2 Analogue, for Intermittent Claudication : A Double-Blind, Randomized, Multicenter Controlled Trial Circulation, July 25, 2000; 102(4): 426 - 431. [Abstract] [Full Text] [PDF]
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L. Papoz, A. Ponton, P. Segond, F. Becker, L. Drouet, J. Levenson, M. Marazanof, Y. Sentou, E. Chollet, J. Etiemble, et al. Feasibility and Reliability of Ankle/Arm Blood Pressure Index in Preventive Medicine Angiology, June 1, 2000; 51(6): 463 - 471. [Abstract] [PDF]
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 F.-E. de Leeuw, J. C. de Groot, M. Oudkerk, J. A. Kors, A. Hofman, J. van Gijn, and M. M. B. Breteler Atrial fibrillation and the risk of cerebral white matter lesions Neurology, May 9, 2000; 54(9): 1795 - 1801. [Abstract] [Full Text] [PDF]
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 M. Ho, D. Veale, C. Eastmond, G. Nuki, and J. Belch Macrovascular disease and systemic sclerosis Ann Rheum Dis, January 1, 2000; 59(1): 39 - 43. [Abstract] [Full Text]
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G. C Leng, G. S Taylor, A. J Lee, F G. R Fowkes, and D. Horrobin Essential fatty acids and cardiovascular disease: the Edinburgh Artery Study Vascular Medicine, November 1, 1999; 4(4): 219 - 226. [Abstract] [PDF]
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K. A. Burek, K. Sutton-Tyrrell, M. M. Brooks, B. Naydeck, N. Keller, M. A. Sellers, G. Roubin, R.u. Jandova, and C. S. Rihal Prognostic importance of lower extremity arterial disease in patients undergoing coronary revascularization in the bypass angioplasty revascularization investigation (BARI) J. Am. Coll. Cardiol., September 1, 1999; 34(3): 716 - 721. [Abstract] [Full Text] [PDF]
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P. C. G. Simons, A. Algra, M. L. Bots, D. E. Grobbee, and Y. van der Graaf Common Carotid Intima-Media Thickness and Arterial Stiffness : Indicators of Cardiovascular Risk in High-Risk PatientsThe SMART Study (Second Manifestations of ARTerial disease) Circulation, August 31, 1999; 100(9): 951 - 957. [Abstract] [Full Text] [PDF]
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K. Kroger, A. Kucharczik, H. Hirche, and G. Rudofsky Atherosclerotic Lesions Are More Frequent in Femoral Arteries than in Carotid Arteries Independent of Increasing Number of Risk Factors Angiology, August 1, 1999; 50(8): 649 - 654. [Abstract] [PDF]
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