EDINBURGH ARTERY STUDY - PREVALENCE OF ASYMPTOMATIC AND SYMPTOMATIC PERIPHERAL ARTERIAL-DISEASE IN THE GENERAL-POPULATION
EDINBURGH ARTERY STUDY - PREVALENCE OF ASYMPTOMATIC AND SYMPTOMATIC PERIPHERAL ARTERIAL-DISEASE IN THE GENERAL-POPULATION
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DOI：
10.1093/ije/20.2.384
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发表时间：
1991-06-01
影响因子：
7.7
通讯作者：
PRESCOTT, RJ
中科院分区：
文献类型：
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作者：
FOWKES, FGR;HOUSLEY, E;PRESCOTT, RJ
间歇性跛行已经在心血管调查中进行了研究，但关于无症状外周动脉疾病的信息有限。本文的目的是描述爱丁堡动脉研究中无症状和有症状疾病的患病率及其与缺血性心脏病的关系。本研究采用横断面调查方法，选取了本市10家全科医院年龄性别登记的55 ~ 74岁男性和女性，按年龄分层抽样。通过世卫组织关于间歇性跛行、测量踝关节肱收缩压指数（ABPI）和反应性充血期间踝关节收缩压变化的问卷，对1592名参与者的动脉疾病进行了评估。间歇性跛行发生率为4.5%（95%可信区间（Cl）： 3.5%-5.5%）。8.0%发生严重无症状疾病，导致血流严重受损（95% Cl: 6.6%-9.4%）。另有16.6% （95% Cl: 14.6%-18.5%）的患者在临床实践中有异常标准：9.0%的患者ABPI < 0.9, 7.6%的患者反应性充血血压降低20%。间歇性跛行在两性中同样常见。ABPI和反应性充血结果提示无症状疾病在男性中略有优势，并且与年龄和社会阶层较低的患病率增加相一致。正常男性的平均ABPI高于女性，左腿比右腿低，表明单侧易患疾病。有重大无症状疾病的受试者比正常人群有更多的缺血性心脏病的证据（相对危险度（RR） 1.6; 95% Cl: 1.3-1.9）。综上所述，影响下肢的重大无症状动脉粥样硬化在普通人群中常见，并与缺血性心脏病相关，因此需要进一步研究其自然史和预防重大血管事件的前景。
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 hyperaemia. The prevalence of intermittent claudication was 4.5% (95% confidence interval (Cl): 3.5%-5.5%). Major asymptomatic disease causing a significant impairment of blood flow occurred in 8.0% (95% Cl: 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% Cl: 1.3-1.9). In conclusion, major asymptomatic 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.