Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis
Identifieur interne : 005708 ( PascalFrancis/Curation ); précédent : 005707; suivant : 005709Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis
Auteurs : F. Gerald R. Fowkes [Royaume-Uni] ; Diana Rudan [Royaume-Uni, Croatie] ; Igor Rudan [Royaume-Uni] ; Victor Aboyans [France] ; Julie O. Denenberg [États-Unis] ; Mary M. Mcdermott [États-Unis] ; Paul E. Norman [Australie] ; Uchechukwe K. A. Sampson [États-Unis] ; Linda J. Williams [Royaume-Uni] ; George A. Mensah [États-Unis] ; Michael H. Criqui [États-Unis]Source :
- Lancet : (British edition) [ 0140-6736 ] ; 2013.
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- Wicri :
English descriptors
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Abstract
Background Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke. This study provides the first comparison of the prevalence of peripheral artery disease between high-income countries (HIC) and low-income or middle-income countries (LMIC), establishes the primary risk factors for peripheral artery disease in these settings, and estimates the number of people living with peripheral artery disease regionally and globally. Methods We did a systematic review of the literature on the prevalence of peripheral artery disease in which we searched for community-based studies since 1997 that defined peripheral artery disease as an ankle brachial index (ABI) lower than or equal to 0.90. We used epidemiological modelling to define age-specific and sex-specific prevalence rates in HIC and in LMIC and combined them with UN population numbers for 2000 and 2010 to estimate the global prevalence of peripheral artery disease. Within a subset of studies, we did meta-analyses of odds ratios (ORs) associated with 15 putative risk factors for peripheral artery disease to estimate their effect size in HIC and LMIC. We then used the risk factors to predict peripheral artery disease numbers in eight WHO regions (three HIC and five LMIC). Findings 34 studies satisfied the inclusion criteria, 22 from HIC and 12 from LMIC, including 112027 participants, of which 9347 had peripheral artery disease. Sex-specific prevalence rates increased with age and were broadly similar in HIC and LMIC and in men and women. The prevalence in HIC at age 45-49 years was 5.28% (95% CI 3.38-8.17%) in women and 5.41% (3.41-8.49%) in men, and at age 85-89 years, it was 18.38% (11.16-28.76%) in women and 18.83% (12.03-28.25%) in men. Prevalence in men was lower in LMIC than in HIC (2.89% [2.04-4.07%] at 45-49 years and 14.94% [9.58-22.56%] at 85-89 years). In LMIC, rates were higher in women than in men, especially at younger ages (6.31% [4.86-8.15%] of women aged 45-49 years). Smoking was an important risk factor in both HIC and LMIC, with meta-OR for current smoking of 2.72 (95% CI 2.39-3.09) in HIC and 1.42 (1.25-1.62) in LMIC, followed by diabetes (1.88 [1.66-2.14] vs 1.47 [1.29-1.68]), hypertension (1.55 [1.42-1.71] vs 1.36 [1.24-1.50]), and hypercholesterolaemia (1.19 [1.07-1.33] vs 1.14 [1.03-1.25]). Globally, 202 million people were living with peripheral artery disease in 2010, 69.7% of them in LMIC, including 54.8 million in southeast Asia and 45.9 million in the western Pacific Region. During the preceding decade the number of individuals with peripheral artery disease increased by 28.7% in LMIC and 13.1% in HIC. Interpretation In the 21st century, peripheral artery disease has become a global problem. Governments, non-governmental organisations, and the private sector in LMIC need to address the social and economic consequences, and assess the best strategies for optimum treatment and prevention of this disease.
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>2000-2010</term>
<term>Artery</term>
<term>Comparative study</term>
<term>Disease</term>
<term>Epidemiology</term>
<term>Estimation</term>
<term>Medicine</term>
<term>Prevalence</term>
<term>Risk factor</term>
<term>Systematic review</term>
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<term>Estimation</term>
<term>Prévalence</term>
<term>Epidémiologie</term>
<term>Facteur risque</term>
<term>Artère</term>
<term>Maladie</term>
<term>2000-2010</term>
<term>Revue systématique</term>
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<front><div type="abstract" xml:lang="en">Background Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke. This study provides the first comparison of the prevalence of peripheral artery disease between high-income countries (HIC) and low-income or middle-income countries (LMIC), establishes the primary risk factors for peripheral artery disease in these settings, and estimates the number of people living with peripheral artery disease regionally and globally. Methods We did a systematic review of the literature on the prevalence of peripheral artery disease in which we searched for community-based studies since 1997 that defined peripheral artery disease as an ankle brachial index (ABI) lower than or equal to 0.90. We used epidemiological modelling to define age-specific and sex-specific prevalence rates in HIC and in LMIC and combined them with UN population numbers for 2000 and 2010 to estimate the global prevalence of peripheral artery disease. Within a subset of studies, we did meta-analyses of odds ratios (ORs) associated with 15 putative risk factors for peripheral artery disease to estimate their effect size in HIC and LMIC. We then used the risk factors to predict peripheral artery disease numbers in eight WHO regions (three HIC and five LMIC). Findings 34 studies satisfied the inclusion criteria, 22 from HIC and 12 from LMIC, including 112027 participants, of which 9347 had peripheral artery disease. Sex-specific prevalence rates increased with age and were broadly similar in HIC and LMIC and in men and women. The prevalence in HIC at age 45-49 years was 5.28% (95% CI 3.38-8.17%) in women and 5.41% (3.41-8.49%) in men, and at age 85-89 years, it was 18.38% (11.16-28.76%) in women and 18.83% (12.03-28.25%) in men. Prevalence in men was lower in LMIC than in HIC (2.89% [2.04-4.07%] at 45-49 years and 14.94% [9.58-22.56%] at 85-89 years). In LMIC, rates were higher in women than in men, especially at younger ages (6.31% [4.86-8.15%] of women aged 45-49 years). Smoking was an important risk factor in both HIC and LMIC, with meta-OR for current smoking of 2.72 (95% CI 2.39-3.09) in HIC and 1.42 (1.25-1.62) in LMIC, followed by diabetes (1.88 [1.66-2.14] vs 1.47 [1.29-1.68]), hypertension (1.55 [1.42-1.71] vs 1.36 [1.24-1.50]), and hypercholesterolaemia (1.19 [1.07-1.33] vs 1.14 [1.03-1.25]). Globally, 202 million people were living with peripheral artery disease in 2010, 69.7% of them in LMIC, including 54.8 million in southeast Asia and 45.9 million in the western Pacific Region. During the preceding decade the number of individuals with peripheral artery disease increased by 28.7% in LMIC and 13.1% in HIC. Interpretation In the 21st century, peripheral artery disease has become a global problem. Governments, non-governmental organisations, and the private sector in LMIC need to address the social and economic consequences, and assess the best strategies for optimum treatment and prevention of this disease.</div>
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<fA11 i1="02" i2="1"><s1>RUDAN (Diana)</s1>
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<fA11 i1="06" i2="1"><s1>MCDERMOTT (Mary M.)</s1>
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<fA11 i1="07" i2="1"><s1>NORMAN (Paul E.)</s1>
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<fA11 i1="08" i2="1"><s1>SAMPSON (Uchechukwe K. A.)</s1>
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<fA11 i1="09" i2="1"><s1>WILLIAMS (Linda J.)</s1>
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<fA11 i1="10" i2="1"><s1>MENSAH (George A.)</s1>
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<s2>Edinburgh</s2>
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<s3>HRV</s3>
<sZ>2 aut.</sZ>
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<s2>Limoges</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
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<fA14 i1="04"><s1>INSERM U1094, Tropical Neuro-epidemiology</s1>
<s2>Limoges</s2>
<s3>FRA</s3>
<sZ>4 aut.</sZ>
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<fA14 i1="05"><s1>Department of Family and Preventive Medicine, University of California</s1>
<s2>San Diego, CA</s2>
<s3>USA</s3>
<sZ>5 aut.</sZ>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Department of Medicine and Preventive Medicine, Northwestern University Feinberg School</s1>
<s2>Chicago, IL</s2>
<s3>USA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>School of Surgery, University of Western Australia</s1>
<s2>Fremantle, WA</s2>
<s3>AUS</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Cardiovascular Medicine Division, Vanderbilt University Medical Center</s1>
<s2>Nashville, TN</s2>
<s3>USA</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Immediate Office of the Director, National Heart, Lung, and Blood Institute, National Institutes of Health</s1>
<s2>Bethesda, MD</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA20><s1>1329-1340</s1>
</fA20>
<fA21><s1>2013</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>5004</s2>
<s5>354000508224780100</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2013 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>71 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>13-0327371</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Lancet : (British edition)</s0>
</fA64>
<fA66 i1="01"><s0>GBR</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Background Lower extremity peripheral artery disease is the third leading cause of atherosclerotic cardiovascular morbidity, following coronary artery disease and stroke. This study provides the first comparison of the prevalence of peripheral artery disease between high-income countries (HIC) and low-income or middle-income countries (LMIC), establishes the primary risk factors for peripheral artery disease in these settings, and estimates the number of people living with peripheral artery disease regionally and globally. Methods We did a systematic review of the literature on the prevalence of peripheral artery disease in which we searched for community-based studies since 1997 that defined peripheral artery disease as an ankle brachial index (ABI) lower than or equal to 0.90. We used epidemiological modelling to define age-specific and sex-specific prevalence rates in HIC and in LMIC and combined them with UN population numbers for 2000 and 2010 to estimate the global prevalence of peripheral artery disease. Within a subset of studies, we did meta-analyses of odds ratios (ORs) associated with 15 putative risk factors for peripheral artery disease to estimate their effect size in HIC and LMIC. We then used the risk factors to predict peripheral artery disease numbers in eight WHO regions (three HIC and five LMIC). Findings 34 studies satisfied the inclusion criteria, 22 from HIC and 12 from LMIC, including 112027 participants, of which 9347 had peripheral artery disease. Sex-specific prevalence rates increased with age and were broadly similar in HIC and LMIC and in men and women. The prevalence in HIC at age 45-49 years was 5.28% (95% CI 3.38-8.17%) in women and 5.41% (3.41-8.49%) in men, and at age 85-89 years, it was 18.38% (11.16-28.76%) in women and 18.83% (12.03-28.25%) in men. Prevalence in men was lower in LMIC than in HIC (2.89% [2.04-4.07%] at 45-49 years and 14.94% [9.58-22.56%] at 85-89 years). In LMIC, rates were higher in women than in men, especially at younger ages (6.31% [4.86-8.15%] of women aged 45-49 years). Smoking was an important risk factor in both HIC and LMIC, with meta-OR for current smoking of 2.72 (95% CI 2.39-3.09) in HIC and 1.42 (1.25-1.62) in LMIC, followed by diabetes (1.88 [1.66-2.14] vs 1.47 [1.29-1.68]), hypertension (1.55 [1.42-1.71] vs 1.36 [1.24-1.50]), and hypercholesterolaemia (1.19 [1.07-1.33] vs 1.14 [1.03-1.25]). Globally, 202 million people were living with peripheral artery disease in 2010, 69.7% of them in LMIC, including 54.8 million in southeast Asia and 45.9 million in the western Pacific Region. During the preceding decade the number of individuals with peripheral artery disease increased by 28.7% in LMIC and 13.1% in HIC. Interpretation In the 21st century, peripheral artery disease has become a global problem. Governments, non-governmental organisations, and the private sector in LMIC need to address the social and economic consequences, and assess the best strategies for optimum treatment and prevention of this disease.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B01</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B30A01A</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Etude comparative</s0>
<s5>02</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Comparative study</s0>
<s5>02</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Estudio comparativo</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Estimation</s0>
<s5>03</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Estimation</s0>
<s5>03</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Estimación</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Prévalence</s0>
<s5>05</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Prevalence</s0>
<s5>05</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Prevalencia</s0>
<s5>05</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Epidémiologie</s0>
<s5>06</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Epidemiology</s0>
<s5>06</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Epidemiología</s0>
<s5>06</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Facteur risque</s0>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Risk factor</s0>
<s5>08</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Factor riesgo</s0>
<s5>08</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Artère</s0>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Artery</s0>
<s5>09</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Arteria</s0>
<s5>09</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Maladie</s0>
<s5>11</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Disease</s0>
<s5>11</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Enfermedad</s0>
<s5>11</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>2000-2010</s0>
<s5>12</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>2000-2010</s0>
<s5>12</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>2000-2010</s0>
<s5>12</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Revue systématique</s0>
<s2>FM</s2>
<s5>17</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Systematic review</s0>
<s2>FM</s2>
<s5>17</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Revisión sistemática</s0>
<s2>FM</s2>
<s5>17</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Médecine</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Medicine</s0>
<s5>18</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Medicina</s0>
<s5>18</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Appareil circulatoire</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Circulatory system</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Vaisseau sanguin</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Blood vessel</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Vaso sanguíneo</s0>
<s5>38</s5>
</fC07>
<fN21><s1>308</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>
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