Weragoda Janaka, Seneviratne Rohini, Weerasinghe Manuj C, Wijeyaratne Mandika, Samaranayaka Anil
Ministry of Health, Colombo, Sri Lanka.
Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
BMC Public Health. 2015 Aug 28;15:829. doi: 10.1186/s12889-015-2174-7.
Peripheral arterial disease (PAD), a slowly progressive atherosclerotic disease affecting vital organs of the body, is increasingly recognized as a health burden worldwide. Epidemiological information on peripheral arterial disease is scarce in Sri Lanka. The present study intended to estimate the prevalence and associated factors of PAD among adults aged 40-74 years in Gampaha district, Sri Lanka.
A cross-sectional study was carried out to estimate the prevalence of PAD among adults aged 40-74 years in four randomly selected divisional secretariat areas in Gampaha district in 2012-2013. The sample size of 2912 adults was obtained from 104 clusters using multistage probability proportionate to size sampling. The number of individuals to be included in the 5-year age groups between 40 and 74 years was determined based on the population proportion of the respective age groups in the district. Cluster size was 28, and equal numbers of males and females were selected for each age group per cluster. PAD was defined as having an ankle-brachial pressure index ≤ 0.89.
The age-and sex-standardized prevalence of PAD, adjusted for the sensitivity of the ankle-brachial pressure index was 3.6% (95% CI 2.9-4.3%), and no significant difference was found between males (3.7%) and females (3.6%) (p = 0.08). Eighty-eight individuals were newly identified as having PAD, and a significant trend of prevalence with increasing age was observed (p < 0.001). Histories of diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, cerebrovascular accident, smoking, and erectile dysfunction among males were significantly associated with PAD (p < 0.001). Only one third of those with PAD experienced claudication symptoms.
PAD was found to be a hidden disease in the Gampaha district population. Although there is minimal attention on PAD at present, the disease is likely to become a problematic public health concern in Sri Lanka, particularly with its aging population. Primary prevention measures to modify risk factors of PAD, including screening activities for early identification, should be a priority.
外周动脉疾病（PAD）是一种影响身体重要器官的缓慢进展性动脉粥样硬化疾病，在全球范围内日益被视为一种健康负担。斯里兰卡关于外周动脉疾病的流行病学信息匮乏。本研究旨在估计斯里兰卡甘巴哈地区40 - 74岁成年人中PAD的患病率及相关因素。
2012 - 2013年，在甘巴哈地区四个随机选取的分区秘书处区域开展了一项横断面研究，以估计40 - 74岁成年人中PAD的患病率。采用按规模大小成比例的多阶段概率抽样方法，从104个群组中抽取了2912名成年人作为样本。40至74岁之间5岁年龄组纳入的个体数量根据该地区各年龄组的人口比例确定。群组规模为28，每个群组的每个年龄组选取相等数量的男性和女性。PAD定义为踝臂压力指数≤0.89。
经踝臂压力指数敏感性校正后的年龄和性别标准化PAD患病率为3.6%（95%可信区间2.9 - 4.3%），男性（3.7%）和女性（3.6%）之间未发现显著差异（p = 0.08）。新发现88例患有PAD的个体，且观察到患病率随年龄增长有显著趋势（p < 0.001）。男性的糖尿病、高血压、血脂异常、冠状动脉疾病、脑血管意外、吸烟和勃起功能障碍病史与PAD显著相关（p < 0.001）。只有三分之一的PAD患者出现间歇性跛行症状。
在甘巴哈地区人群中，PAD被发现是一种隐匿性疾病。尽管目前对PAD的关注较少，但在斯里兰卡，该疾病可能会成为一个有问题的公共卫生问题，尤其是考虑到其人口老龄化。改变PAD危险因素的一级预防措施，包括早期识别的筛查活动，应成为优先事项。
