Collins Tracie C, Petersen Nancy J, Suarez-Almazor Maria, Ashton Carol M
Houston Center for Quality of Care and Utilization Studies, Houston Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Arch Intern Med. 2003 Jun 23;163(12):1469-74. doi: 10.1001/archinte.163.12.1469.
The purpose of this study was to determine the prevalence of peripheral arterial disease (PAD) in white, African American, and English- and Spanish-speaking Hispanic patients.
We screened patients older than 50 years for PAD at 4 primary care clinics located in the Houston Veterans Affairs Medical Center and the Harris County Hospital District. The disease was diagnosed by an ankle-brachial index of less than 0.9. Patients also completed questionnaires to ascertain symptoms of intermittent claudication, walking difficulty, medical history, and quality of life.
We enrolled 403 patients (136 whites; 136 African Americans; and 131 Hispanics, 81 of whom were Spanish speaking). The prevalence of PAD was 13.2% among whites, 22.8% among African Americans, and 13.7% among Hispanics (P =.06). African Americans had a significantly higher prevalence of PAD than whites and Hispanics combined (P =.02). Among all patients who were diagnosed as having PAD on the basis of their ankle-brachial index, only 5 (7.5%) had symptoms of intermittent claudication.
Peripheral arterial disease is a prevalent illness in the primary care setting. Its prevalence varies by race and is higher in African Americans than in whites and Hispanics. Relative to the prevalence of PAD, the prevalence of intermittent claudication is low. Since measurement of the ankle-brachial index is not part of the routine clinic visit, many patients with PAD are not diagnosed unless they develop symptoms of intermittent claudication. Because of this, it is likely that many patients remain undiagnosed. Efforts are needed to improve PAD detection in the primary care setting.
本研究旨在确定白人、非裔美国人以及讲英语和西班牙语的西班牙裔患者外周动脉疾病（PAD）的患病率。
我们在休斯顿退伍军人事务医疗中心和哈里斯县医院区的4家初级保健诊所，对50岁以上的患者进行PAD筛查。通过踝臂指数小于0.9来诊断该疾病。患者还完成了问卷，以确定间歇性跛行症状、行走困难、病史和生活质量。
我们纳入了403名患者（136名白人；136名非裔美国人；131名西班牙裔，其中81名讲西班牙语）。PAD的患病率在白人中为13.2%，在非裔美国人中为22.8%，在西班牙裔中为13.7%（P = 0.06）。非裔美国人的PAD患病率显著高于白人和西班牙裔的总和（P = 0.02）。在所有根据踝臂指数被诊断为患有PAD的患者中，只有5名（7.5%）有间歇性跛行症状。
外周动脉疾病在初级保健环境中是一种常见疾病。其患病率因种族而异，非裔美国人高于白人和西班牙裔。相对于PAD的患病率，间歇性跛行的患病率较低。由于踝臂指数测量并非常规门诊检查的一部分，许多患有PAD的患者除非出现间歇性跛行症状否则无法被诊断。因此，很可能有许多患者仍未被诊断。需要做出努力以改善初级保健环境中PAD的检测。
