Cited by 1,885Peripheral Artery Disease ManagementVascular Procedures and ComplicationsHealthcare Systems and Public Health

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Prevalence of and Risk Factors for Peripheral Arterial Disease in the United States: Results From the National Health and Nutrition Examination Survey, 1999–2000

Selvin, Elizabeth, Erlinger, Thomas P.·2004·Circulation

DOI 10.1161/01.cir.0000137913.26087.f0

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Abstract

Background— Peripheral arterial disease (PAD) is associated with significant morbidity and mortality and is an important marker of subclinical coronary heart disease. However, estimates of PAD prevalence in the general US population have varied widely. Methods and Results— We analyzed data from 2174 participants aged 40 years and older from the 1999–2000 National Health and Nutrition Examination Survey. PAD was defined as an ankle-brachial index <0.90 in either leg. The prevalence of PAD among adults aged 40 years and over in the United States was 4.3% (95% CI 3.1% to 5.5%), which corresponds to ≈5 million individuals (95% CI 4 to 7 million). Among those aged 70 years or over, the prevalence was 14.5% (95% CI 10.8% to 18.2%). In age- and gender-adjusted logistic regression analyses, black race/ethnicity (OR 2.83, 95% CI 1.48 to 5.42) current smoking (OR 4.46, 95% CI 2.25 to 8.84), diabetes (OR 2.71, 95% CI 1.03 to 7.12), hypertension (OR 1.75, 95% CI 0.97 to 3.13), hypercholesterolemia (OR 1.68, 95% CI 1.09 to 2.57), and low kidney function (OR 2.00, 95% CI 1.08 to 3.70) were positively associated with prevalent PAD. More than 95% of persons with PAD had 1 or more cardiovascular disease risk factors. Elevated fibrinogen and C-reactive protein levels were also associated with PAD. Conclusions— This study provides nationally representative prevalence estimates of PAD in the United States, revealing that PAD affects more than 5 million adults. PAD prevalence increases dramatically with age and disproportionately affects blacks. The vast majority of individuals with PAD have 1 or more cardiovascular disease risk factors that should be targeted for therapy.

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Association of serum aryl hydrocarbon receptor activity and RBC omega-3 polyunsaturated fatty acids with flow-mediated dilation in healthy, young Hispanic cigarette smokers
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Albuminuria Is the Stronger Risk Factor for Peripheral Arterial Disease than eGFR Decline in a Type 2 Diabetic Taiwanese Population
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“] also reported an increase in the incidence of peripheral arterial disease in those with chronic kidney disease. The association of chronic kidney disease and peripheral artery disease has been mentioned in some cross-sectional studies [ , , , ,”
Background
Plasma adiponectin is associated with ankle‐brachial index in patients on haemodialysis
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Self-Reported Peripheral Arterial Disease Predicts Future Vascular Events in a Community-Based Cohort
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Clinical and Economic Burden in Patients with Diagnosis of Peripheral Arterial Disease in a Claims Database in Japan
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Sex-related differences in outcomes after vascular interventions
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Cardiovascular events in chronic myeloid leukemia clinical trials. Is it time to reassess and report the events according to cardiology guidelines?
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Free-Breathing Fast Low-Angle Shot Quiescent-Interval Slice-Selective Magnetic Resonance Angiography for Improved Detection of Vascular Stenoses in the Pelvis and Abdomen
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Peripheral arterial occlusive disease
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Visit to Visit Hemoglobin A1c Variation and Long-term Risk of Major Adverse Limb Events in Patients With Type 2 Diabetes
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“It is estimated that possibly 25% or more of adults age > 80 years have PAD [4, 5].”
Neutrophil-to-lymphocyte ratio in type 2 diabetes patients combined with Lower Extremity Peripheral Artery Disease
Li, L., Wang, M., Jia, T., Jiang, X., Yang, F., Wang, Z., & Zhang, X. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1434580 · Cited by 9
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Cataract increases the risk of peripheral artery occlusive disease: A nationwide population-based cohort study with propensity score
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Endovascular Therapy Research in Lower Limb Peripheral Arterial Disease Published Over a 5-Year Period: Who is Publishing and Where?
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Natural Activators of Autophagy Increase Maximal Walking Distance and Reduce Oxidative Stress in Patients with Peripheral Artery Disease: A Pilot Study
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“Moreover, both traditional cardiovascular disease risk factors, such as current smoking, diabetes, hypertension, and hypercholesterolemia, as well as non-traditional risk factors such as fibrinogen and C-reactive protein, were positively associated with PAD, reflecting the high burden of atherosclerosis in these patie…”
Background
Clinical correlates of red blood cell omega-3 fatty acid content in male veterans with peripheral arterial disease
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“PAD patients also have significantly elevated risks of limb amputation and premature mortality compared with the general population.(1,26) To our knowledge, a characterization of O3I levels among patients with PAD has not yet”
Background
Vascular Disease Prevalence and Risk Factors in a Screened Korean Male Population
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Peripheral Arterial Disease and Clinical Risks in Taiwanese Hemodialysis Patients
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High-Sensitivity C-Reactive Protein is Not Independently Associated with Peripheral Subclinical Atherosclerosis
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Are Toe Pressures Measured by a Portable Photophlethysmograph Equivalent to Standard Laboratory Tests?
Bonham, P. A., Kelechi, T. J., Mueller, M., & Robison, J. G. (2010) · Journal of Wound Ostomy and Continence Nursing · doi:10.1097/won.0b013e3181eda0c5 · Cited by 9
Vascular calcifications on the preoperative radiograph: harbinger of tourniquet failure in patients undergoing total knee arthroplasty?
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Acute aortoiliac occlusive disease during percutaneous transluminal angioplasty in the setting of ST-elevation myocardial infarction: a case report
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Ankle brachial index (ABI) in a cohort of older women in the Philippines: Prevalence of peripheral artery disease and predictors of ABI
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Prevalence of foot ulcers in dialysis‐dependent patients
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Hemoglobin A1c monitoring practices before lower extremity bypass in patients with diabetes vary broadly and do not predict outcomes
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Intensive exercise therapy for restenosis after superficial femoral artery stenting: the REASON randomized clinical trial
Kato, T., Miura, T., Yamamoto, S., Miyashita, Y., Hashizume, N., Shoin, K., Sasaki, S., Kanzaki, Y., Yui, H., Maruyama, S., et al. (2022) · Heart and Vessels · doi:10.1007/s00380-022-02060-9 · Cited by 9
Closing the Gaps in Racial Disparities in Critical Limb Ischemia Outcome and Amputation Rates: Proceedings from a Society of Interventional Radiology Foundation Research Consensus Panel
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Authors: Selvin, E., & Erlinger, T. P.
Affiliations: Johns Hopkins University (US)
ORCID: Selvin, Elizabeth
Erlinger, Thomas P.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-08-10
Volume: 110
Issue: 6
Pages: 738-743
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000137913.26087.f0
OpenAlex: W2100049802
Semantic Scholar: 086852e793552793c625312acd69ee172fc265e6
Cited by: 1,885
References: 28
Citations by year: 2026: 37 · 2025: 53 · 2024: 78 · 2023: 88 · 2022: 84 · 2021: 67 · 2020: 74 · 2019: 73 · 2018: 90 · 2017: 92 · 2016: 103 · 2015: 112 · 2014: 120 · 2013: 138 · 2012: 139
FWCI: 55.28
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (T32 HL 07024, T32HL007024)
Topics: Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
Keywords: peripheral arterial disease, prevalence, risk factors, ankle-brachial index, cardiovascular risk factors, smoking, diabetes mellitus, hypertension, hypercholesterolemia, renal function, fibrinogen, C-reactive protein, racial disparities, older adults
MeSH terms: Adult, Aged, Aged, 80 and over, Blood Pressure Determination, Brachial Artery, C-Reactive Protein, Cross-Sectional Studies, Diabetes Mellitus, Female, Fibrinogen, Glomerular Filtration Rate, Health Surveys, Humans, Hypercholesterolemia, Hypertension, Kidney Diseases, Male, Middle Aged, Risk Factors, Smoking, United States, Biomarkers, Comorbidity, Prevalence, Peripheral Vascular Diseases, Tibial Arteries, Racial Groups

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Prevalence of and Risk Factors for Peripheral Arterial Disease in the United States: Results From the National Health and Nutrition Examination Survey, 1999–2000

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