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Men’s risks for peripheral arterial disease

PAD most likely in men with high BP, lipids and diabetes who smoke

Louise Prime

Wednesday, 24 October 2012

Smoking, hypertension, hypercholesterolaemia and type 2 diabetes are all strongly and independently associated with men’s risk of developing peripheral arterial disease, research published today in JAMA has shown. Risk was also cumulative, increasing with the number and duration of risk factors.

As part of the Health Professionals Follow-up Study, US researchers followed nearly 44,985 men, with no history of cardiovascular disease when the study began in 1986, for a median of 24.2 years. Their risk factors – including smoking, hypertension, hypercholesterolaemia and type 2 diabetes – were recorded biennially.

During follow up, 537 of the men developed PAD. Almost all (96%) of these had at least one of the four risk factors at the time of diagnosis. Men with none of the four risk factors were 77% less likely to develop PAD than all the other men in the group.

Each risk factor was independently, significantly associated with the risk of incident PAD. All men with a risk factor, however long they’d had it, were more likely to develop PAD than men without risk factors; and each additional risk factor roughly doubled men’s risk of developing PAD.

The longer men had had type 2 diabetes and hypercholesterolaemia, or the longer they had smoked, the more their risk of PAD tended to increase; risk was also higher among men who had a history of hypertension and had used one, or two or more, antihypertensive medicines, compared with risk in men with hypertension but no current use of antihypertensive drugs.

The authors concluded: “In this well-characterised cohort of US men followed up for longer than two decades, smoking, hypertension, hypercholesterolemia, and type 2 diabetes each demonstrated strong, graded, and independent associations with risk of clinically significant PAD.”

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