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Multicenter Study
. 2017 May 3;6(5):e003796.
doi: 10.1161/JAHA.116.003796.

Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study

Corey A Kalbaugh  1 , Anna Kucharska-Newton  2   3 , Lisa Wruck  4 , Jennifer L Lund  2 , Elizabeth Selvin  5 , Kunihiro Matsushita  5 , Lindsay G S Bengtson  6 , Gerardo Heiss  2 , Laura Loehr  2
Affiliations
Multicenter Study

Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study

Corey A Kalbaugh et al. J Am Heart Assoc. .

Abstract

Background: Outpatient ascertainment of peripheral artery disease (PAD) is rarely considered in the measurement of PAD clinical burden; therefore, the clinical burden of PAD likely has been underestimated while contributing to a decreased awareness of PAD in comparison to other circulatory system disorders.

Methods and results: The purpose of this study was to estimate the age-standardized annual period prevalence and incidence of PAD in the outpatient and inpatient settings using data from the Atherosclerosis Risk in Communities (ARIC) study linked with Centers for Medicare and Medicaid Services claims. The majority (>70%) of all PAD encounters occurred in the outpatient setting. The weighted mean age-standardized prevalence and incidence of outpatient PAD was 11.8% (95% CI 11.5-12.1) and 22.4 per 1000 person-years (95% CI 20.8-24.0), respectively. Black patients had higher weighted mean age-standardized prevalence (15.6%; 95% CI 14.6-16.4) compared with white patients (11.4%; 95% CI 11.1-11.7). Black women had the highest weighted mean age-standardized prevalence (16.9%; 95% CI 16.0-17.8). Black patients also had a higher incidence rate of PAD (31.3 per 1000 person-years; 95% CI 27.3-35.4) compared with white patients (25.4 per 1000 person-years; 95% CI 23.5-27.3). PAD prevalence and incidence did not differ by sex alone.

Conclusions: This study provides comprehensive estimates of PAD in the inpatient and outpatient settings where the majority of PAD burden was found. PAD is an important circulatory system disorder similar in prevalence to stroke and coronary heart disease.

Keywords: Atherosclerosis Risk in Communities; Medicare; aging; claims; epidemiology; peripheral artery disease; population science.

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Figures

Figure 1
Figure 1
Age‐standardized annual prevalence of peripheral artery disease (PAD) by age group. The ARIC (Atherosclerosis Risk in Communities) study, 2003–2012. Estimates are standardized to the 2005 Medicare population.
Figure 2
Figure 2
Age‐standardized annual prevalence (percentage) of peripheral artery disease (PAD) by race group. The ARIC (Atherosclerosis Risk in Communities) study, 2003–2012. Estimates are age‐standardized to 2005 Medicare population.
Figure 3
Figure 3
Age‐standardized annual incidence (per 1000 person‐years) of peripheral artery disease (PAD) by age group. The ARIC (Atherosclerosis Risk in Communities) study, 2005–2012. Estimates are age‐standardized to 2005 Medicare population; rates are per 1000 person‐years.
Figure 4
Figure 4
Age‐standardized annual incidence of peripheral artery disease (PAD; per 1000 person‐years), by race groups. The ARIC (Atherosclerosis Risk in Communities) study, 2005–2012. Estimates are age‐standardized to 2005 population; rates are per 1000 person‐years.
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