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High prevalence of peripheral arterial disease in elderly hypertensive patients in primary care: getABI study
Hohe Prävalenz der AVK bei älteren Hypertonikern in der Hausarztpraxis: Ergebnisse des Querschnittsteils der getABI Studie
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Veröffentlicht: | 11. November 2004 |
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Peripheral arterial occlusive disease (PAD) is a common condition in elderly patients. PAD patients carry a high risk of other atherothrombotic manifestations, namely cerebrovascular (CVD) and coronary heart disease (CHD). We aimed to compare the prevalence of PAD in hypertensive vs. normotensive patients and to assess the blood pressure (BP) control status of these patients.
In 344 representative primary care practices across Germany, a total of 6,880 unselected patients aged = 65 years (58% females, mean age 72.5 years, mean body mass index 27 kg/m2, 25% diabetics) were included in the cross-sectional part of the observational German Trial on ankle-brachial index (getABI). In the total cohort, the prevalence of PAD for men/women as indicated by an ABI< 0.9 was 19.8%/16.8% (total: 18.0%).
(1) In patients with the clinical diagnosis hypertension, the prevalence of PAD was much higher than in patients without the diagnosis (22% vs. 11%, p<0.001); vice versa, PAD patients were assigned more often the diagnosis hypertension than patients without PAD (79% vs. 62%, OR: 2.2). (2) Blood pressure control in hypertensive PAD patients was significantly worse than in hypertensive patients without PAD (mean systolic BP 151 vs. 147 mmHg, p<0.001) . (3) In contrast, hypertensive patients with the clinical diagnosis CHD and/or CVD had a better blood pressure control than those hypertensive patients without CHD and/or CVD (mean systolic BP 146 vs. 149 mmHg; p<0.001)
The present large-scale study in primary care highlights the substantial PAD burden in unselected elderly patients in primary care. PAD and the clinical diagnosis hypertension occur very often concomitantly, however, hypertension is less effectively treated in PAD patients. The early diagnosis of PAD is of particular importance, as treatment intensity (with antihypertensives, antiplatelets etc.) should be optimized in those high risk patients.