The distribution of peripheral arterial disease in a defined population of elderly high-risk Saudi patients

Objectives. To find out the prevalence rate of peripheral arterial disease (PAD) in a defined population of high risk Saudi patients aged 50-80 years, using simple measuring techniques. Design: A hospital-based cross-sectional study using a simple protocol. Materials and methods. Four groups of patients were studied: three high risk groups (214 cases of diabetes (DS), 60 of chronic renal failure (CRF), 78 of ischaemic heart disease (IHD) and 50 controls. PAD was only diagnosed if the ankle-brachial index (ABI) was less than or equal to 0.9. The contribution of a history of intermittent claudication (IC) and palpation of pulses to the diagnosis was assessed. Results: A total of 402 patients was studied. Their mean age was 59.31 +/- 8.1 (range 50-80). There were 257 males (63.9%) and 145 females (36.1%). 171 cases of PAD were detected (42.5%) and distributed among the various groups: 105 (61.4%) in the DM, 23 (13.4%) in the CRF, 36 (21.4%) in the IHD and 7 (4.1%) in the control groups. The prevalence rate was highly significant in each of the 3 high risk groups compared to the control group; however, there was no statistically significant difference in the incidence of PAD between the high risk groups. Questionnaires for IC and palpation of peripheral pulses were of very limited validity in diagnosing PAD. Overall, DM headed the list of significant risk factors followed by smoking and greater age. Conclusions. In contrast to the general impression that PAD is an uncommon disease, we found a significant prevalence rate of PAD in elderly high risk patients. Screening for PAD in aged diabetics, IHD and CRF patients is a simple and cost-effective approach.