Prevalence of peripheral arterial disease and its association with smoking in a population-based study in Beijing, China

Abstract

Objective: Although the prevalence of peripheral arterial disease (PAD) and its association with smoking in Western populations has been extensively studied, little information is available in China. The objective of this study was to determine the age-standardized prevalence of PAD and examine the relationship between smoking, quitting, and PAD in elderly Chinese.

Methods: We conducted a population-based cross-sectional study in an urban Beijing sample of 2334 subjects aged > or =60 years (943 men and 1391 women) in 2001 to 2002. PAD was assessed by symptoms of intermittent claudication (IC) as measured by the WHO/Rose questionnaire and an ankle-arm systolic blood pressure index (AAI) of <0.90.

Results: The prevalence of PAD defined by IC was 11.3% (men, 8.0%; women, 13.6%); 15.3% (men, 11.7%; women, 17.7%) by AAI, and 19.8% (men, 14.7%; women, 23.2%) by both criteria. After adjusting for age, gender, marital status, education, alcohol drinking, exercise, body mass index, and histories of hypertension and diabetes mellitus, the odds ratios and 95% confidence intervals of PAD for current smokers vs never smokers were 1.54 (1.12 to 2.11) and 1.28 (0.91 to 1.79) for former smokers (stopped smoking for at least 2 years). There was a dose-response relation between the number of cigarettes smoked and increasing risk of PAD. Quitting for > or =10 years nearly eliminated excess risk associated with smoking.

Conclusions: PAD is common in elderly Chinese and the prevalence is higher in women than in men. About 40% of PAD patients were asymptomatic and unaware of their condition. Cigarette smoking is a major risk factor for PAD, and smoking cessation substantially reduces the risk.