Four Factors Account for Most of Risk Linked to PAD in Men

Population-attributable risk for smoking, HTN, hypercholesterolemia, type 2 diabetes 75 percent

TUESDAY, Oct. 23 (HealthDay News) -- Smoking, hypertension, high cholesterol, and type 2 diabetes account for most of the risk for developing peripheral artery disease (PAD) among men, according to a study published in the Oct. 24 issue of the Journal of the American Medical Association.

Michel M. Joosten, Ph.D., from Harvard Medical School in Boston, and colleagues conducted a prospective study to examine the combined effects of four conventional cardiovascular risk factors on PAD. A cohort of 44,985 U.S. men with no history of cardiovascular disease at baseline, from the Health Professionals Follow-up Study, was followed for 25 years until January 2011.

The researchers found that there were 537 cases of incident PAD. After adjusting for the other three risk factors and confounders, each risk factor was significantly and independently associated with a higher risk of PAD. The age-adjusted incidence rate per 100,000 person-years was nine cases for zero risk factors; 23 cases for one risk factor; 47 cases for two risk factors; 92 cases for three risk factors; and 186 cases for four risk factors. For each additional risk factor, the multivariable-adjusted hazard ratio was 2.06. The hazard ratio for men without any risk factors was 0.23 compared with all other men in the cohort. At least one of the four risk factors was present in 96 percent of men with PAD. There was a 75 percent population-attributable risk associated with these four risk factors.

"In conclusion, in this well-characterized cohort of U.S. men followed up for longer than two decades, smoking, hypertension, hypercholesterolemia, and type 2 diabetes each demonstrated strong, graded, and independent associations with risk of clinically significant PAD," the authors write.

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