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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.
Article info
Publication history
Accepted:
January 5,
2023
Received in revised form:
December 12,
2022
Received:
October 10,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 The Author(s). Published by Elsevier B.V. on behalf of European Society for Vascular Surgery.
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- Contemporary Cardiovascular Epidemiological Data: A Message from the Heart of HamburgersEuropean Journal of Vascular and Endovascular Surgery
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