Diabetes Mellitus, Smoking, and the Risk for Asymptomatic Peripheral Arterial Disease: Whom Should We Screen?
Open accessAbstract
OBJECTIVE: To describe coexisting medical conditions and lifestyle factors associated with asymptomatic peripheral arterial disease (PAD) in a population of white, African American, and Hispanic patients. STUDY DESIGN AND SETTING: White, African American, and Hispanic patients 50 years or older were recruited for this cross-sectional study from 4 primary care clinics in Houston, TX. Patients with an ankle-brachial index (ABI) < 0.9 and without leg symptoms typical of PAD were diagnosed with asymptomatic PAD. RESULTS: 403 patients were screened for PAD. Of these, 25 (6.2%) had asymptomatic PAD. Compared with patients without PAD, diabetes mellitus ([OR] 3.8; 95% CI 1.6, 9.0) and a history of smoking at least 1 pack of cigarettes per day ([OR] 2.5; 95% CI 1.1, 6.0) were significantly associated with asymptomatic PAD. An interaction effect existed between diabetes mellitus and smoking at least 1 pack of cigarettes per day. Diabetes mellitus combined with heavy smoking showed the highest predicted value positive (15%) and the highest specificity (92%). A lack of both demonstrated low rates for predicting asymptomatic PAD (predicted value positive, 1%). CONCLUSION: The ankle-brachial index could become routine screening among patients with diabetes mellitus and/or who smoke.
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Up to two-thirds of people with asymptomatic PAD have been shown to have comorbid diabetes.
“Conversely, up to twothirds of people with asymptomatic PAD have been shown to have comorbid diabetes (236).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [236]
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- Authors
- Eason, S. L., Petersen, N. J., Suarez-Almazor, M., Davis, B., & Collins, T. C.
- Affiliations
- Baylor College of Medicine (US)
- Veterans Health Administration (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2005-09-01
- Volume
- 18
- Issue
- 5
- Pages
- 355-361
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W2131999434
- Cited by
- 55
- References
- 38
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 2 · 2021: 2 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 3 · 2012: 3
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Topics
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
- Keywords
- asymptomatic peripheral arterial disease, diabetes mellitus, smoking, ankle-brachial index, PAD screening, risk factors, African American patients, Hispanic patients, Caucasian patients, heavy smoking, comorbidities
- MeSH terms
- Aged, Aged, 80 and over, Brachial Artery, Cross-Sectional Studies, Diabetes Mellitus, Diabetic Angiopathies, Female, Humans, Male, Mass Screening, Middle Aged, Regional Blood Flow, Smoking, Comorbidity, Peripheral Vascular Diseases, Risk Assessment
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