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Epidemiology of Peripheral Vascular Disease

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Diabetes and Cardiovascular Disease

Abstract

The epidemiology of several atherosclerotic arterial diseases and their association with diabetes will be covered in this chapter. This chapter will focus on peripheral vascular disease (PVD), arterial disease affecting the extremities, and will include more general epidemiological aspects of PVD, including associated conditions and mortality. Additionally, the epidemiology of cerebrovascular disease (CBD) and coronary artery disease (CAD) will also be discussed, primarily as they relate to diabetes.

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References

  1. Boyko EJ, Alderman BW, Baron AE. Reference test errors bias the evaluation of diagnostic tests for ischemic heart disease. J Gen Intern Med 1988;3:476–481.

    Article  PubMed  CAS  Google Scholar 

  2. Young MJ, Anderson GF, Boulton AJ, Cavanaugh PR. Medial arterial calcification in the feet of diabetic patients and matched non-diabetic control subjects. Diabetolgia 1993;36:615–621.

    Article  CAS  Google Scholar 

  3. Rothman KJ. Modern Epidemiology. Philadelphia: Lippincott-Raven, 1998.

    Google Scholar 

  4. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care 2003;26:3333–3341.

    Article  Google Scholar 

  5. Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly: The Rotterdam Study. Arterioscler Thromb Vasc Biol 1998;18:185–192.

    PubMed  CAS  Google Scholar 

  6. Curb JD, Kamal M, Rodriguez BL, et al. Peripheral artery disease and cardiovascular risk factors in the elderly. The Honolulu Heart Program. Arterioscler Thromb Vasc Biol 1996;16(12):1495–1500.

    PubMed  CAS  Google Scholar 

  7. Hirsch A, Treat-Jacobson D, Regensteiner J, et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA 2001;286:1317–1324.

    Article  PubMed  CAS  Google Scholar 

  8. Criqui MH, Denenberg JO, Langer RD, Fronek A. The epidemiology of peripheral arterial disease: importance of identifying the population at risk. Vasc Med 1997;2(3):221–226.

    PubMed  CAS  Google Scholar 

  9. Leng GC, Fowkes FG. The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys. J Clin Epidemiol 1992;45:1101–1109.

    Article  PubMed  CAS  Google Scholar 

  10. Fowkes FG. Epidemiology of peripheral vascular disease. Atherosclerosis 1997;131(Suppl):S29–S31.

    Article  PubMed  CAS  Google Scholar 

  11. Hale WE, Marks RG, May FE, Moore MT, Stewart RB. Epidemiology of intermittent claudication: evaluation of risk factors. Age Ageing 1988;17:57–60.

    Article  PubMed  CAS  Google Scholar 

  12. Orchard TJ, Maser RE, Becker DJ, et al. Prevalence of complications in IDDM by sex and duration. Pittsburgh Epidemiology of Diabetes Complications Study II. Diabetes 1990;39(9):1116–1124.

    Article  PubMed  CAS  Google Scholar 

  13. Nathan DM, Lachin J, Cleary P, et al. Intensive diabetes therapy and carotid intima-media thickness in type 1 diabetes mellitus. N Engl J Med 2003;348(23):2294–2303.

    Article  PubMed  Google Scholar 

  14. Adler AI, Neil A, Stratton IM, Boulton AJM, Holman RR, for the UK Prospective Diabetes Study Group. UKPDS 59: hyperglycemia and other potentially modifiable risk factors for peripheral vascular disease in type 2 diabetes. Diabetes Care 2002;25:894–899.

    Article  PubMed  Google Scholar 

  15. Murabito JM, Nieto K, Larson MG, Levy D, Wilson PWF. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J 2002;143:961–965.

    Article  PubMed  Google Scholar 

  16. Halperin JL. Arterial obstructive diseases of the extremities. In: Loscalzo CM, Dzau VJ, (eds). Vascular Medicine. Boston: Little Brown, 1992, pp. 835–865.

    Google Scholar 

  17. LoGerfo FW, Coffman JD. Current Concepts. Vascular and microvascular disease of the foot in diabetes. Implications in foot care. N Engl J Med 1984;311:1615–1619.

    Article  PubMed  CAS  Google Scholar 

  18. Jude EB, Oyibo SO, Chalmers N, Boulton AJ. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care 2001;24(8):1433–1437.

    Article  PubMed  CAS  Google Scholar 

  19. Hutchinson RG, Davis CE, Barnes R, et al. Racial differences in risk factors for atherosclerosis. Angiology 1997;48(4):279–290.

    Article  PubMed  CAS  Google Scholar 

  20. Resnick HE, Valsania P, Phillips CL. Diabetes mellitus and nontraumatic lower extremity amputation in black and white Americans: the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, 1971–1992. Arch Intern Med 1999;159:2470–2475.

    Article  PubMed  CAS  Google Scholar 

  21. Karter AJ, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA 2002;287(19):2519–2527.

    Article  PubMed  Google Scholar 

  22. Kannel WB, McGee D, Gordon T. A general cardiovascular risk profile: the Framingham Study. Am J Cardiol 1976;38(1):46–51.

    Article  PubMed  CAS  Google Scholar 

  23. Fowkes FG, Housley E, Riemersma RA, et al. Smoking, lipids, glucose tolerance, and blood pressure as risk factors for peripheral atherosclerosis compared with ischemic heart disease in the Edinburgh Artery Study. Am J Epidemiol 1992;135(4):331–340.

    PubMed  CAS  Google Scholar 

  24. Price JF, Mowbray PI, Lee AJ, Rumley A, Lowe GD, Fowkes FG. Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease: Edinburgh Artery Study. Eur Heart J 1999;20(5):344–353.

    Article  PubMed  CAS  Google Scholar 

  25. Liese AD, Mayer-Davis EJ, Haffner SM. Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev 1998;20:157–172.

    PubMed  CAS  Google Scholar 

  26. Lee AJ, MacGregor AS, Hau CM, et al. The role of haematological factors in diabetic peripheral arterial disease: the Edinburgh artery study. Br J Haematol 1999;105(3):648–654.

    Article  PubMed  CAS  Google Scholar 

  27. Kannel WB, McGee DL. Update on some epdemiologic features of intermittant claudication: the Framingham Study. J Am Geriatr Soc 1985;33(1):13–18.

    PubMed  CAS  Google Scholar 

  28. Ogren M, Hedblad B, Isacsson SO, Janzon L, Jungquist G, Lindell SE. Non-invasively detected carotid stenosis and ischaemic heart disease in men with leg arteriosclerosis. Lancet 1993;342(8880):1138–1141.

    Article  PubMed  CAS  Google Scholar 

  29. Newman AB, Siscovick DS, Monolio TA, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Researac Group. Circulation 1993;88:837–845.

    PubMed  CAS  Google Scholar 

  30. Adler AI, Stratton IM, Neil HA, et al., on behalf of the the UK Prospective Diabetes Study Group. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000;321:412–419.

    Article  PubMed  CAS  Google Scholar 

  31. Aschoff L. Observations concerning the relationship between cholesterol metabolism and vascular disease. BMJ 1932;2:1121.

    Article  Google Scholar 

  32. Malinow MR, Kang SS, Taylor LM, et al. Prevalence of hyperhomo-cyst(e)inemia in patients with peripheral occlusive disease. Circulation 1989;79:1180–1188.

    PubMed  CAS  Google Scholar 

  33. Robinson K, Arheart K, Refsum H, et al. Low circulating folate and vitamin B6 concentrations: risk factors for stroke, peripheral vascular disease, and coronary artery disease. European COMAC Group [see comments]. Circulation 1998;97(5):437–443.

    PubMed  CAS  Google Scholar 

  34. Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, vitamin B6 on clinical outcome after percutaneous coronary intervention. JAMA 2002;288(8):973–979.

    Article  PubMed  CAS  Google Scholar 

  35. Lowe GD, Dawes J, Donnan PT, Lennie SE, Housley SE. Blood viscosity, fibrinogen, and activation of coagulation and leukocytes in peripheral arterial disease and the normal population in the Edinburgh Artery Study. Circulation 1993;87:1915–1920.

    PubMed  CAS  Google Scholar 

  36. Lee AJ, Fowkes FG, Lowe GD, Rumley A. Fibrin D-dimer, haemostatic factors and peripheral arterial disease. Thromb Haemost 1995;74:828–832.

    PubMed  CAS  Google Scholar 

  37. Cook PJ, Lip GY. Lip, Infectious agents and atherosclerotic vascular disease. QJM 1996;89(10):727–735.

    PubMed  CAS  Google Scholar 

  38. Gibbs RG, Carey N, Davies AH. Chlamydia pneumoniae and vascular disease. Br J Surg 1998;85(9):1191–1197.

    Article  PubMed  CAS  Google Scholar 

  39. Martyn CN, Gale CR, Jespersen S, Sherriff SB. Impaired fetal growth and atherosclerosis of carotid and peripheral arteries. Lancet 1998;352(9123):173–178.

    Article  PubMed  CAS  Google Scholar 

  40. Hales CN, Desai M, Ozanne SE. The Thrifty Phenotype hypothesis: how does it look after 5 years? Diabet Med 1997;14(3):189–195.

    Article  PubMed  CAS  Google Scholar 

  41. Bainton D, Sweetman P, Baker I, Elwood P. Peripheral vascular disease: consequence for survival and association with risk factors in the Speedwell prospective heart disease study. Br Heart J 1994;72(2):128–132.

    Article  PubMed  CAS  Google Scholar 

  42. Allan PL, Mowbray PI, Lee AJ, Fowkes GR. Relationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study. Stroke 1997;28(2):348–353.

    PubMed  CAS  Google Scholar 

  43. Peabody CN, Karrnel WB, McNamara PM. Intermittant claudication. Surgical significance. Arch Surg 1974;109(5):693–697.

    PubMed  CAS  Google Scholar 

  44. Szilagyi DE, Smith RF, Elliott JP, Brown F, Dietz P. Autogenous vein grafting in femorpopliteal atherosclerosis: the limits of its effectiveness. Surgery 1979;86:836–851.

    PubMed  CAS  Google Scholar 

  45. DeWeese JA, Rob CG. Autogenous venous grafts ten years later. Surgery 1977;82(6):755–784.

    PubMed  CAS  Google Scholar 

  46. Criqui MH, Langer RD, Fronek A, et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 1992;326(6):381–386.

    Article  PubMed  CAS  Google Scholar 

  47. Simonsick EM, Guralnik JM, Hennekens CH, Wallace RB, Ostfeld AM. Intermittent claudication and subsequent cardiovascular disease in the elderly. J Gerontol A Biol Sci Med Sci 1995;50A:M17–M22.

    PubMed  CAS  Google Scholar 

  48. Howell MA, Colgan MP, Seeger RW, Ramsey DE, Sumner DS. Relationship of severity of lower limb peripheral vascular disease to mortality and morbidity: a six-year follow-up study. J Vasc Surg 1989;9(5):691–696.

    Article  PubMed  CAS  Google Scholar 

  49. Hankey G. Stroke: how large a public health problem, and how can the neurologist help? Arch Neurol 1999;56:748–754.

    Article  PubMed  CAS  Google Scholar 

  50. Chambless LE, Folsom AR, Clegg LX, et al. Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol 2000;151(5):478–487.

    PubMed  CAS  Google Scholar 

  51. Wagenknecht LE Jr, D’Agostino RB, Haffner SM, Savage PJ, Rewers M. Impaired glucose tolerance, type 2 diabetes, and carotid wall thickness: the Insulin Resistance Atherosclerosis Study. Diabetes Care 1998;21(11):1812–1818.

    Article  PubMed  CAS  Google Scholar 

  52. Howard G, Zaccaro D, Haffner S, et al. Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 1996;93:1809–1817.

    PubMed  CAS  Google Scholar 

  53. Sharrett AR, Sorlie PD, Chambless LE, et al. Relative importance of various risk factors for asymptomatic carotid atherosclerosis versus coronary heart disease incidence: the Atherosclerosis Risk in Communities Study. Am J Epidemiol 1999;149(9):843–852.

    PubMed  CAS  Google Scholar 

  54. Ebrahim S, Papacosta O, Whincup P, et al. Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in med and women: the British Regional Heart Study. Stroke 1999;30(4):841–850.

    PubMed  CAS  Google Scholar 

  55. Anonymous. Effect of intensive diabetes treatment on carotid artery wall thickness in the epidemiology of diabetes interventions and complications. Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. Diabetes 1999;48(2):383–390.

    Google Scholar 

  56. Anonymous. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study Group. Lancet 1998;352(9131):837–853.

    Google Scholar 

  57. Decline in deaths from heart disease and stroke—United States 1900–1999. MMWR Morb Mortal Wkly Rep 1999;48(30):649–656.

    Google Scholar 

  58. Minino AM, Smith BL. Deaths: preliminary data for 2000. Natl Vital Stat Rep 2001;49(12):1–40.

    CAS  Google Scholar 

  59. Changes in mortality from heart failure—United States 1980–1995. MMWR Morb Mortal Wkly Rep 1998;47(30):633–637.

    Google Scholar 

  60. Croft JB, Giles WH, Pollard RA, Casper ML, Anda RF, Livengood JR. National trends in the initial hospitalization for heart failure. J Am Geriatr Soc 1997;45(3):270–275.

    PubMed  CAS  Google Scholar 

  61. Alexander CM, Landsman PB, Teutsch SM. Diabetes mellitus, impaired fasting glucose, atherosclerotic risk factors, and prevalence of coronary heart disease. Am J Cardiol 2000;86(9):897–902.

    Article  PubMed  CAS  Google Scholar 

  62. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care 1999;22(2):233–240.

    Article  PubMed  CAS  Google Scholar 

  63. Smith NL, Barzilay JI, Shaffer D, et al. Fasting and 2-hour postchallenge serum glucose measures and risk of incident cardiovascular events in the elderly: the Cardiovascular Health Study. Arch Intern Med 2002;162(2):209–216.

    Article  PubMed  Google Scholar 

  64. Qiao Q, Pyorala K, Pyorala M, et al. Two-hour glucose is a better risk predictor for incident coronary heart disease and cardiovascular mortality than fasting glucose. Eur Heart J 2002;23(16): p 1267–75.

    Article  PubMed  CAS  Google Scholar 

  65. Isomaa B, Almgren P, Tuomi T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24(4):683–689.

    Article  PubMed  CAS  Google Scholar 

  66. Hedblad B, Nilsson P, Engstrom G, Berglund G, Janzon L. Insulin resistance in non-diabetic subjects is associated with increased incidence of myocardial infarction and death. Diabet Med 2002;19(6):470–475.

    Article  PubMed  CAS  Google Scholar 

  67. Lundberg V, Stegmayr B, Asplund K, Eliasson M, Huhtasaari F. Diabetes as a risk factor for myocardial infarction: population and gender perspectives. J Intern Med 1997;241(6):485–492.

    Article  PubMed  CAS  Google Scholar 

  68. Tavani A, Bertuzzi M, Gallus S, Negri E, La Vecchia C. Diabetes mellitus as a contributor to the risk of acute myocardial infarction. J Clin Epidemiol 2002;55(11):1082–1087.

    Article  PubMed  Google Scholar 

  69. Kuller LH, Velentgas P, Barzilay J, Beauchamp NJ, O’Leary DH, Savage PJ. Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality. Arterioscler Thromb Vasc Biol 2000;20(3):823–829.

    PubMed  CAS  Google Scholar 

  70. Cho E, Rimm EB, Stampfer MJ, Willett WC, Huf B. The impact of diabetes mellitus and prior myocardial infarction on mortality from all causes and from coronary heart disease in men. J Am Coll Cardiol 2002;40(5):954–960.

    Article  PubMed  Google Scholar 

  71. Lotufo PA, Gaziano JM, Chae CV, et al. Diabetes and all-cause and coronary heart disease mortality among US male physicians. Arch Intern Med 2001;161(2):242–247.

    Article  PubMed  CAS  Google Scholar 

  72. Hu FB, Stampfer MJ, Solomon GG, et al. The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20years of follow-up. Arch Intern Med 2001;161(14):1717–1723.

    Article  PubMed  CAS  Google Scholar 

  73. Gillum RF, Mussolino ME, Madans JH. Diabetes mellitus, coronary heart disease incidence, and death from all causes in African American and European American women: The NHANES I epidemiologic follow-up study. J Clin Epidemiol 2000;53(5):511–518.

    Article  PubMed  CAS  Google Scholar 

  74. Gillum RF, Mussolino ME, Madans JH. Coronary heart disease incidence and survival in African-American women and men. The NHANES I Epidemiologic Follow-up Study. Ann Intern Med 1997;127(2):111–118.

    PubMed  CAS  Google Scholar 

  75. Ethnicity and cardiovascular disease. The incidence of myocardial infarction in white, South Asian, and Afro-Caribbean patients with type 2 diabetes (U.K. Prospective Diabetes Study 32). Diabetes Care 1998;21(8):1271–1277.

    Google Scholar 

  76. Turner RC, Millns H, Neil HA, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316(7134):823–828.

    PubMed  CAS  Google Scholar 

  77. Haffner SM. Lipoprotein disorders associated with type 2 diabetes mellitus and insulin resistance. Am J Cardiol 2002;90(8A):55i–61i.

    Article  PubMed  CAS  Google Scholar 

  78. Solfrizzi V, Panza F, Colacicco AM, et al. Relation of lipoprotein(a) as coronary risk factor to type 2 diabetes mellitus and low-density lipoprotein cholesterol in patients < or = 65 years of age (The Italian Longitudinal Study on Aging). Am J Cardiol 2002;89(7):825–829.

    Article  PubMed  CAS  Google Scholar 

  79. Laakso M, Lehtos, Penttlia I, Pyorala K. Lipids and lipoproteins predicting coronary heart disease mortality and morbidity in patients with non-insulin-dependent diabetes. Circulation 1993;88(4 Pt 1):1421–1430.

    PubMed  CAS  Google Scholar 

  80. Barrett-Connor ET, Philippi, Khaw KT. Lipoproteins as predictors of ischemic heart disease in non-insulin-dependent diabetic men. Am J Prev Med 1987;3(4):206–210.

    PubMed  CAS  Google Scholar 

  81. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA 2002;287(19):2570–2581.

    Article  PubMed  CAS  Google Scholar 

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Wheeler, S.G., Smith, N.L., Boyko, E.J. (2005). Epidemiology of Peripheral Vascular Disease. In: Johnstone, M.T., Veves, A. (eds) Diabetes and Cardiovascular Disease. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-908-7:419

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  • DOI: https://doi.org/10.1385/1-59259-908-7:419

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