Peripheral artery disease and cardiovascular risk factors

Introduction: Multiple risk factors are involved in the pathogenesis of peripheral arterial disease (PAD). Some studies show that high blood pressure is a very strong risk factor in combination with dyslipidemia, but relatively weak in its absence. Increased levels of plasma lipids are constantly encountered in patients with PAD. Smoking remains certainly an important risk factor for developing this disease. The aim of the study is to make a comprehensive assessment of cardiovascular risk factors and their relationship with PAD. Methods: We analyzed 179 patients hospitalized in the Clinic of Cardiovascular Rehabilitation of Clinic Rehabilitation Hospital in Iași, between 1st of January 2012 and 31st of December 2013, who had hospital discharge diagnosis of PAD. Besides PAD stage, the following cardiovascular risk factors were analyzed: age, gender, body mass index (BMI), waist circumference (WC), smoking, diabetes, arterial hypertension and its degree. Other parameters were also evaluated: left ventricular ejection fraction (EF), ankle-brachial index (ABI), lipid parameters (total cholesterol, triglycerides, HDL, LDL, nonHDL), glycemia, creatinine and uric acid. Study groups were divided according to the PAD stage (from stage I to stage IV). Results: Th e patient’s average age is 62.11 ± 8.57 years. Along with the advance in age the stage of the PAD also increases (p = 0.02). Higher WC is associated with an advanced stage of PAD. An upper stage of PAD is correlated to a rise of the procent of former smokers (42% – stage I to 66% – stage IV). Th ere are no signifi cant differences regarding prevalence of diabetes and hypertension. As the stage of the PAD advances, the ABI is significantly lower (p = 0.0001). Surgical revascularization is more frequent in patients with PAD stage III than in stage II (p = 0.001). EF decreases as the PAD advances (61% – stage I to 57% – stage IV). Th e highest lipid parameters are seen in patients with PAD stage III and the seric creatinine rises along with the advance of PAD, but without statistic significance. Conclusions: A higher PAD stage is associated with an advanced age and with an increase in revascularization recommendation. The increase in the PAD stage is direct proportional with the number of former smokers possibly because of the understanding of the negative effects of smoking and its consequences. Th e ABI decreases as the PAD advances. In the current study there are no significant statistic differences between patients with diff erent PAD stages and their lipid parameters and EF.

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