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Prevalence of peripheral arterial disease, abdominal aortic aneurysm, and risk factors in the Hamburg City Health Study: A Cross-Sectional Analysis

  • Christian-Alexander Behrendt
    Correspondence
    Corresponding author: Research Group GermanVasc, Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, Twitter: @VASCevidence. Telephone: +49-40-7410-18087. Telefax: +49-40-7410-54840
    Affiliations
    Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    German Center for Cardiovascular Research (DZHK) Partner Site Hamburg–Kiel–Lübeck
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  • Götz Thomalla
    Affiliations
    Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • David Leander Rimmele
    Affiliations
    Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Elina Larissa Petersen
    Affiliations
    Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Raphael Twerenbold
    Affiliations
    University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    German Center for Cardiovascular Research (DZHK) Partner Site Hamburg–Kiel–Lübeck

    Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Eike Sebastian Debus
    Affiliations
    Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Tilo Kölbel
    Affiliations
    Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Stefan Blankenberg
    Affiliations
    Department of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Christian Schmidt-Lauber
    Affiliations
    III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Author Footnotes
    † The authors contributed equally
    Frederik Peters
    Footnotes
    † The authors contributed equally
    Affiliations
    Department of Vascular Medicine, University Heart and Vascular Center UKE Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Author Footnotes
    † The authors contributed equally
    Birgit-Christiane Zyriax
    Footnotes
    † The authors contributed equally
    Affiliations
    Midwifery Science-Health Services Research and Prevention, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
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  • Author Footnotes
    † The authors contributed equally
Open AccessPublished:January 09, 2023DOI:https://doi.org/10.1016/j.ejvs.2023.01.002
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      Abstract

      Introduction

      There is a paucity of current figures on the prevalence of carotid and lower extremity peripheral arterial disease (PAD) and abdominal aortic aneurysm (AAA) as well as associated cardiovascular risk factors to support considerations on screening programmes.

      Methods

      In the population-based Hamburg City Health Study participants between 45 and 74 years were randomly recruited. In the current cross-sectional analysis of the first 10,000 participants enrolled between February 2016 and November 2018, the prevalence of carotid artery disease (intima-media thickness ≥1mm), lower extremity PAD (ankle-brachial index ≤0.9), and AAA (aortic diameter ≥30mm) was determined. Multivariate logistic regression models were applied to determine the association between vascular diseases and risk factors. To account for missing values, multiple imputation was performed.

      Results

      A total of 10,000 participants were analysed (51.1% females, median 63 years, median body-mass-index 26,1 kg/m2). In median, the intima-media thickness was 0.74mm (IQR 0.65-0.84), the ankle-brachial-index 1.04 (IQR 0.95-1.13), and the aortic diameter 17.8mm (IQR 16.1-19.6). Concerning risk factors, 64% self-reported any smoking, 39% hypertension, 5% coronary artery disease, 3% congestive heart failure, 5% atrial fibrillation, and 3% history of stroke or myocardial infarction, respectively. In males, the prevalence of carotid artery disease, lower extremity PAD, and AAA were 35.3%, 22.7%, and 1.3%, respectively. In their female counterparts, 23.4%, 24.8%, and 0.2%, respectively. Higher age and current smoking were likewise associated with higher prevalence while the impact of variables varied widely.

      Conclusion

      In this large population-based cohort study of 10,000 subjects from Hamburg, Germany, a strikingly high prevalence of PAD was revealed. Almost 45% suffered from any index disease, while AAA was only diagnosed in 1.3% of males and 0.2% of females. The high prevalence of atherosclerotic disease and associated cardiovascular risk factors underline that it is essential to increase awareness and fuel efforts for secondary prevention.

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