Risk factors and cardiovascular diseases associated with asymptomatic peripheral arterial occlusive disease: The Limburg PAOD Study

Jd, Hooi; Stoffers, Jelle; Ad, Kester; Pe, Rinkens; Kaiser,; Jw, van Ree; Ja, Knottnerus

doi:10.1080/028134398750003142

Cited by 106 publications

(9 citation statements)

References 9 publications

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“…It is valid also after adjustment for age [17,18] and supports the notion that IC should be more common in men [2,19-21]. IC was indeed more common in men in the few early IC prevalence studies that enrolled women [20,22], but more recent publications report a sex neutral prevalence [23-25].…”

Section: Discussionsupporting

confidence: 61%

Differences in presentation of symptoms between women and men with intermittent claudication

Sigvant

Lundin

Nilsson

et al. 2011

BMC Cardiovasc Disord

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BackgroundMore women than men have PAD with exception for the stage intermittent claudication (IC). The purpose of this study was to evaluate differences in disease characteristics between men and women when using current diagnostic criteria for making the diagnosis IC, defined as ABI < 0.9 and walking problems.Study DesignCohort studyMethods5040 elderly (median age 71) subjects participated in a point-prevalence study 2004. They had their ABI measured and filled out questionnaires covering medical history, current medication, PAD symptoms and walking ability. The prevalence of IC was 6.5% for women and 7.2% for men (P = 0.09). A subset of subjects with IC (N = 56) was followed up four years later with the same procedures. They also performed additional tests aiming to determine all factors influencing walking ability.ResultsMen with IC had more concomitant cardiovascular disease and a more profound smoking history than women. Women, on the other hand, reported a lower walking speed (P < 0.01) and more joint problems (P = 0.018). In the follow up cohort ABI, walking ability and amount of atherosclerosis were similar among the sexes, but women more often reported atypical IC symptoms.ConclusionSex differences in the description of IC symptoms may influence diagnosis even if objective features of PAD are similar. This may influence accuracy of prevalence estimates and selection to treatment.

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Section: Discussionsupporting

confidence: 61%

Differences in presentation of symptoms between women and men with intermittent claudication

Sigvant

Lundin

Nilsson

et al. 2011

BMC Cardiovasc Disord

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“…In contrast to our initial assumptions, the presence of additional pathology was found irrespective of gender or patient status. We evaluated the incidence of risk factors for PAOD such as hypertension, hyperlipidemia, smoking and diabetes [19,20]. The results of our study could not show an increased number of additional pathologies in patients with the aforementioned risk factors for PAOD.…”

Section: Discussionmentioning

confidence: 99%

Steady state vascular imaging with extracellular gadobutrol: evaluation of the additional diagnostic benefit in patients who have undergone a peripheral magnetic resonance angiography protocol

Ong

Hausotter

Pilz

et al. 2013

Journal of Cardiovascular Magnetic Resonance

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BackgroundTo evaluate the feasibility and additional diagnostic benefit of a high-resolution steady state 3D-volume interpolated breath-hold exam (VIBE) sequence between a continuous table movement (CTM) MR angiography of the entire runoff vasculature and a time-resolved (TWIST) MRA of the calves.MethodsIn this retrospective IRB approved study 224 patients (72 women, 152 men, mean age 67.29 ± 13.9) were included who had undergone a low-dose MR angiographic protocol at 3T (Siemens TimTrio) after injection of 0.1 mmol/kg gadobutrol including a CTM MRA, a time-resolved MRA of the calf station and a steady state 3D VIBE sequence prior to the time-resolved MRA. One board-certified radiologist rated the image quality of the steady state VIBE sequences on an ordinal three point scale (excellent, good, poor) and analyzed the images for additional diagnostic findings of and beyond the vascular system in comparison to the CTM MRA and the time-resolved MRA. Descriptive statistics and demographic patient data were used for further evaluation.ResultsThe image quality of the steady state imaging of the pelvis, upper and lower leg was excellent in up to 88%, 84% and 47%, respectively, while poor image quality was only detected in the upper (2%) and lower leg (6%). An additional diagnostic benefit was found in 44% of the patients overall. The most common relevant pathologies included inflammatory processes of the soft tissues (26%), thrombi (14%), abscesses (13%) and tumors (11%). In subgroups of patients above the age of 60, 65, 70, 75 and 80 years an additional pathology was found in 50% 33%, 44%, 65% and 58%, respectively. There was no significant difference in terms of additional findings between men and women (46% and 39%, p > 0.05) and inpatients and outpatients (42% and 45%, p > 0.05).ConclusionSteady state imaging is also feasible with extracellular contrast agents with good image quality yielding additional diagnostic findings in up to 44% and above in patients older than 60 years of age irrespective of gender or patient status. Given the short acquisition time of 4 minutes this sequence could be added to all peripheral MRA exams.

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“…103,104,106,108,109,111,113,115,116 All but three of the studies showed that greater total obesity (as measured by BMI) was associated with a greater frequency of adverse PAD-related outcomes. 110,115,117 Of the eight studies in which only BMI was assessed, data from five studies showed that total obesity increased the risk of adverse outcomes, such as a more-rapid decline in peak walking distance 109,111 or a cardiovascular event.…”

Section: Body Composition and Risk Of Padmentioning

confidence: 98%

The role of nutrition and body composition in peripheral arterial disease

et al. 2012

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Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost-economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B6 and B12, or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease.

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Risk factors and cardiovascular diseases associated with asymptomatic peripheral arterial occlusive disease: The Limburg PAOD Study

Abstract: Our findings suggest that the risk-factor profile and cardiovascular comorbidity of asymptomatic subjects is comparable to claudicants. Preventive efforts could be made to diminish the influence of especially smoking, diabetes and hypertension in asymptomatic subjects.

Cited by 106 publications

References 9 publications

Differences in presentation of symptoms between women and men with intermittent claudication

Differences in presentation of symptoms between women and men with intermittent claudication

Steady state vascular imaging with extracellular gadobutrol: evaluation of the additional diagnostic benefit in patients who have undergone a peripheral magnetic resonance angiography protocol

The role of nutrition and body composition in peripheral arterial disease

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