Introduction: Peripheral arterial disease (PAD) indicates generalised atherosclerotic disease but is often asymptomatic. The prevalence and potential risk factors of PAD were studied in ECHORN cohort study participants.

Methods: Representative samples of community-dwelling people ≥40 years of age residing in Barbados, Puerto Rico, Trinidad, and the USVI were recruited. The survey included questions on diabetes, hypertension, heart disease and smoking status. Body Mass Index, HbA1c, blood glucose and lipids were determined. Ankle brachial index (ABI) was evaluated in one leg. An oscillometric device measured arm and leg systolic BP simultaneously. ABI classifications were PAD ≤0.90, borderline 0.91 to 0.99, normal 1.00 to 1.40, and non-compressible >0.40. Multivariable logistic regression tested associations of potential risk factors with PAD.

Results: Of 2772 participants (mean age 57.3, 65.2% female), 35.8% were overweight, 38.1% obese, 32.4% had diabetes, 60% hypertension, and 15.4% reported heart. ABI prevalence (95% CI) by category was PAD 4.4% (3.6%, 5.1%), borderline 5.2% (4.4%, 6.1%), normal 87.0% (85.8%, 88.3%) and noncompressible 3.4% (2.7%, 4.0%). Female sex (OR 1.72, 95% CI 1.07 to 2.77), diabetes (OR 2.23, 95% CI 1.47 to 3.4), heart disease history (OR 1.74, 95% CI 1.07 to 2.83) and less than high school education vs having a university degree (OR 2.49, 95% CI 1.19 to 5.22) were independently associated with PAD.

Conclusions: Testing one leg only would underestimate PAD prevalence. Increasing the ABI cutoff for identifying PAD to <1.0 when using oscillometric devices is suggested by some studies but would more than double the estimated prevalence. Guidelines need to address this issue. Female sex and lower educational attainment are important considerations when screening. While diabetes and a history of heart disease were confirmed as risk factors, the lack of association of increasing age and cigarette smoking with PAD was unexpected.

Copyright: © 2024 Adams et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

介绍： 外周动脉疾病（PAD）表明全身性动脉粥样硬化，但常常无症状。ECHORN队列研究参与者中的PAD的患病率及其潜在风险因素被进行了研究。

方法： 从巴巴多斯、波多黎各、特立尼达和美属维尔京群岛招募了≥40岁居住在社区内的代表性样本。调查包括糖尿病、高血压、心脏病以及吸烟状况的问题。测量体重指数（BMI）、糖化血红蛋白（HbA1c）、血糖和血脂。评估一只腿的踝肱指数（ABI）。使用振荡装置同时测定上肢和下肢收缩压。ABI分类为：PAD ≤0.90，临界值 0.91 至 0.99，正常 1.00 至 1.40 和非压缩 >0.40。多变量逻辑回归测试了潜在风险因素与 PAD 的关联。

结果： 在2772名参与者（平均年龄57.3岁，65.2%为女性）中，35.8%超重，38.1%肥胖，32.4%患有糖尿病，60%高血压和15.4%报告有心脏疾病。按类别计算ABI的患病率 (95% CI) 为 PAD 4.4%（3.6%，5.1%），临界值 5.2%（4.4%，6.1%），正常 87.0%（85.8%，88.3%）和非压缩 3.4%（2.7%，4.0%）。女性性别 (OR 1.72，95% CI 1.07 至 2.77)，糖尿病 (OR 2.23，95% CI 1.47 至 3.4)，心脏病史 (OR 1.74，95% CI 1.07 至 2.83) 和低于高中教育程度与拥有大学学位相比（OR 2.49，95% CI 1.19 至 5.22）均独立与PAD相关。

结论： 仅测试一条腿会低估 PAD 的患病率。一些研究表明，在使用振荡装置时将用于识别 PAD 的 ABI 截断值提高到

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