Objective: To determine the age-standardised prevalence of peripheral arterial disease (PAD) and associated risk factors, particularly smoking.
Design: Cross-sectional survey of a randomly selected population.
Setting: Metropolitan area of Perth, Western Australia.
Participants: Men aged between 65-83 years.
Results: The adjusted response traction was 77.2%. Of 4,470 men assessed, 744 were identified as having PAD by the Edinburgh Claudication Questionnaire and/ or the ankle-brachial index of systolic blood pressure, yielding an age-standardised prevalence of PAD of 15.6% (95% confidence intervals (CI): 14.5%: 16.6%). The main risk factors identified in univariate analyses were increasing age, smoking-current (OR = 3.9, 95% CI 2.9-5.1) or former (OR = 2.0, 95% CI 1.6-2.4), physical inactivity (OR = 1.4, 95% CI 1.2-1.7), a history of angina (OR = 2.2, 95% Cl 1.8-2.7) and diabetes mellitus (OR = 2.1, 95% Cl 1.7-2.6). The multivariate analysis showed that the highest relative risk associated with PAD was current smoking of 25 or more cigarettes daily (OR = 7.3, 95% Cl 4.2-12.8). In this population, 32% of PAD was attributable to current smoking and a further 40% was attributable to past smoking by men who did not smoke currently.
Conclusions: This large observational study shows that PAD is relatively common in older, urban Australian men. In contrast with its relationship to coronary disease and stroke, previous smoking appears to have a long legacy of increased risk of PAD.
Implications: This research emphasises the importance of smoking as a preventable cause of PAD.