Pfeiffer M, Bock E, Hohenberger T, Kröger K
German Union of PAD Self-Help Groups.
Vasa. 2008 Nov;37(4):345-52. doi: 10.1024/0301-1526.37.4.345.
Peripheral Arterial Disease in Germany is underestimated with regard to incidence and the consequences. In 1997 the Federal Association of the Peripheral Arterial Disease Self Help Groups started the Arteriomobil Project to increase the awareness for venous and arterial diseases in the general population. We report peripheral arterial disease (PAD) prevalence rates and discuss the unique concept of this project.
The Arteriomobil is a mobile home modified to a simple investigation room with an examination couch, a Doppler equipment and a computer for data acquisition. From April 1997 to April 2007, a total of 14.785 volunteers aged 18 to 102 years (mean age +/- SD: 64 +/- 11 years, 63% females) were investigated. Patients were recruited as a result of their active visit to the Arteriomobil and their active participation in the investigation. In all participants the medical history was documented according to a standardized computer-assisted interview and a standardized Ankle Brachial Index (ABI) determined.
PAD prevalence in females (ABI < 0.9) increased from 2% in the 5th decade of life to 33% in 10th decade and in males from 4.8% to 41% accordingly. Age- and gender-adjusted odds ratios for PAD were highest in smoker: Odds ratio 2.85 (95% Confidence interval 2.5-3.2) and Diabetes mellitus 1.91 (95%CI 1.7-2.2). Hypertension and hypercholesterolemia had a lower impact. Family history of known PAD, CHD or CVD had no impact. Although 49.5% of all participants complained of "leg disorders during exercise" intermittent claudication turned out to be the most discriminating symptom for PAD 5.87 (95%IC 5.18-6.66). Previous myocardial infarction (MI) was the most frequently reported vascular co-morbidity in those with PAD (OR 2.23, 95%IC 1.9-2.7) followed by stroke (2.12, 1.7-2.7), angina pectoris (1.50, 1.3-1.8) and paresis (2.01, 1.6-2.6). The incidence of anti-platelet treatment was significantly higher in participants with coronary heart disease than in those with PAD or cerebrovascular disease.
The Arteriomobil Project is the largest database regarding the prevalence of PAD in the German population. and the data underlines the high prevalence of PAD in Germany.
德国外周动脉疾病的发病率和后果被低估。1997年,外周动脉疾病自助团体联邦协会启动了“动脉移动项目”,以提高普通民众对静脉和动脉疾病的认识。我们报告外周动脉疾病(PAD)的患病率,并讨论该项目的独特理念。
“动脉移动”是一辆改装为简易检查室的移动房屋,配备检查床、多普勒设备和用于数据采集的计算机。1997年4月至2007年4月,共对14785名年龄在18至102岁之间(平均年龄±标准差:64±11岁,63%为女性)的志愿者进行了调查。患者是通过主动前往“动脉移动”并积极参与调查招募而来的。所有参与者均根据标准化的计算机辅助访谈记录病史,并测定标准化的踝臂指数(ABI)。
女性PAD患病率(ABI<0.9)从生命的第5个十年的2%增至第10个十年的33%,男性相应地从4.8%增至41%。PAD的年龄和性别调整后的优势比在吸烟者中最高:优势比为2.85(95%置信区间2.5 - 3.2),糖尿病为1.91(95%CI 1.7 - 2.2)。高血压和高胆固醇血症的影响较小。已知PAD、冠心病或心血管疾病的家族史无影响。尽管所有参与者中有49.5%抱怨“运动时腿部不适”,但间歇性跛行结果显示是PAD最具鉴别性的症状,为5.87(95%IC 5.18 - 6.66)。既往心肌梗死(MI)是PAD患者中最常报告的血管合并症(OR 2.23,95%IC 1.9 - 2.7),其次是中风(2.12,1.7 - 2.7)、心绞痛(1.50,1.3 - 1.8)和轻瘫(2.01,1.6 - 2.6)。冠心病参与者的抗血小板治疗发生率显著高于PAD或脑血管疾病患者。
“动脉移动项目”是关于德国人群PAD患病率的最大数据库,数据强调了德国PAD的高患病率。