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Home > Press Center > Predictors of Premature Peripheral Vascular Disease Revealed

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Emily Kalata
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312.334.2309

The first national study of patients to determine which risk factors are correlated with the development of premature peripheral vascular disease (PVD), has been published in the August 2006 issue of the Journal of Vascular Surgery. 

Peripheral vascular disease involves arteries outside of the heart and brain (generally in the legs and feet) where blood flow has been reduced. These vessels are damaged plaque buildup, often referred to as atherosclerosis. Approximately two percent of the U.S. population, or approximately 1.44 million people are affected by PAD, which can result in cardiovascular morbidity, limb loss and death. 

According to John S. Lane, MD, vascular surgeon and clinical researcher from the University of California, San Francisco, findings were the result of data analysis from the National Health and Nutritional Survey (NHANES). This nationwide survey, completed between 1999-2002, represents the health status of the entire U.S. population.

Investigators compared data from 2,498 subjects younger than 60 years of age with 2,585 subjects 60 and older. The PAD rates, found by measuring and comparing the blood pressure in the arms and legs (ankle brachial index, or ABI), which help determine how well blood is flowing in the body. The rates were approximately two percent in the younger group and 12 percent in the older patients.       

While PVD was much more common in the older subjects, two risk factors–coronary artery disease and elevated serum fibrinogen levels (found by blood tests) were strong predictors for the occurrence of PVD in the younger age group. In the older group however, chronic renal failure was more strongly associated with peripheral vascular disease. 

“The fact that premature PVD also associated with a blood-clotting disorder, due to elevated fibrinogen, is something that we have always suspected,” said Dr. Lane. “However, it takes a study with a large number of subjects, like NHANES, to be able to prove it.”

According to the research team, it was not unusual that atherosclerotic disease in the peripheral vascular bed is found concomitantly with disease in the coronary bed. However, they said they were surprised that PVD and cardiac disease are much more strongly associated in the younger subjects, who are then at much higher risk for also developing heart attack or stroke.

Researchers added that clinicians should be aware of the high risk of developing premature PVD in patients who are younger than 60 years with co-existing CAD or elevated fibrinogen. They noted that screening arm and leg blood pressure measurements in such patients would enhance early detection and allow for secondary intervention for elevated fibrinogen in the form of fibrate or niacin medication. 

According to the study, other predictors of PVD, regardless of age are male gender, smoking and hypertension.