Epidemiology of Peripheral Vascular Disease

ISBN-13: 9781447118916 / Angielski / Miękka / 2011 / 366 str.

F. G. R. Fowkes

Opis

Major epidemiologists from the UK, USA and Europe contribute to the first ever, much needed comprehensive review of the epidemiology of peripheral vascular disease in the lower limbs.

Spis treści

Section I: Measurement in Communities.- 1 Review of Simple Measuring Techniques.- Definition of Atherosclerotic Peripheral Vascular Disease.- Questionnaire for Intermittent Claudication.- Palpation of Peripheral Pulses.- Ankle-Brachial Systolic Pressure Ratio.- Stress Tests.- Exercise.- Reactive Hyperaemia.- Toe Pulse Reappearance Time.- Conclusion: Measurement in Epidemiological Research.- 2 Non-invasive Tests.- Exercise Testing.- Segmental Pressures.- Doppler Ultrasonography.- Plethysmography.- Transcutaneous Oxygen Tension.- Laser Doppler.- Magnetic Resonance Spectroscopy.- Biochemical Parameters.- 3 Questionnaires.- Development of a Questionnaire.- Types of Question.- Wording, Sequence, Layout.- Evaluation of a Questionnaire.- Validity.- Reliability.- Pre-test.- Administered or Self-Âdministered Questionnaires.- WHO/Rose Questionnaire for Intermittent Claudication.- Development of WHO/Rose Questionnaire.- Validation.- Reliability.- Modified Classification.- Edinburgh Claudication Questionnaire.- 4 Duplex Ultrasound.- History.- Basic Principles.- High Resolution Imaging.- Doppler Information.- Ultrasound as a Screening Technique.- Advantages of Ultrasound.- Disadvantages of Ultrasound.- Applications of Duplex as a Screening Technique.- Carotids.- Abdominal Aortic Aneurysms.- Peripheral Vascular Disease.- Venous Disease.- The Future.- 5 Magnetic Resonance Imaging.- The Assessment of Atherosis.- Chemical Shift Imaging.- Velocity Mapping.- The Assessment of Sclerosis.- Aortic Compliance.- Aortic Flow Wave Velocity.- Clinical Importance of Sclerosis.- Section II: Descriptive Epidemiology.- 6 Historical Perspectives and the Basle Study.- The Basle Study.- Population Screening Methods.- Incidence and Prevalence.- Relationship to Coronary Heart Disease.- Risk Factors.- Course of the Disease.- Conclusion.- 7 Large Vessel and Isolated Small Vessel Disease.- Pathophysiology.- Non-invasive Measurement Criteria.- Symptomatology.- Physical Findings.- Prevalence.- Risk Factors.- Natural History.- Morbidity and Mortality.- Future Research.- 8 Symptomatic and Asymptomatic Disease.- Difficulties in Assessing Severity of Disease.- Edinburgh Artery Study: Methods.- Study Population.- Clinical Examination.- Data Analysis.- Edinburgh Artery Study: Symptomatic and Asymptomatic Disease.- Prevalence.- Age and Sex Distribution.- Relationship with Ischaemic Heart Disease.- Possible Bias in Estimating Prevalence of Disease.- Surveys of Symptomatic and Asymptomatic Disease.- 9 Prevalence in General Practice.- Importance of Peripheral Vascular Disease in General Practice.- Methods of Estimating Prevalence.- The Limburg Peripheral Arterial Occlusive Disease (PAOD) Study.- Comparison of Prevalences in Different Studies.- Questions for Further Study.- 10 Intermittent Claudication in Scotland.- The Scottish Heart Health Study.- Prevalence of Intermittent Claudication.- Risk Factors for Intermittent Claudication.- Intermittent Claudication in Epidemiological Studies.- Summary: Scottish Heart Health Study.- Section III: Vascular Risk Factors.- 11 Risk Factors and Cardiovascular Outcome Calf Pain on Walking, Risk Factors and Cardiovascular Outcome in Middle-aged British Men.- British Regional Heart Study: Methods.- Measurement of Calf Pain on Walking.- Follow-up of Subjects.- British Regional Heart Study: Calf Pain on Walking.- Cardiovascular Risk Factors and Calf Pain.- Prevalence of Ischaemic Heart Disease and Calf Pain.- Cardiovascular Mortality and Morbidity and Calf Pain.- Discussion: Calf Pain on Walking.- Prevalence.- Risk Factors.- Outcome.- Summary.- 12 Smoking.- Smoking: The Risk Factor for Peripheral Vascular Disease.- How Does Smoking Cause Peripheral Vascular Disease?.- Smoking and Progression of Peripheral Vascular Disease.- Conclusions: Stop Smoking.- 13 Lipids: Outstanding Questions.- Areas of Agreement.- Outstanding Questions.- Cholesterol and Atheroma.- Regression of Atheroma.- Cholesterol as a Risk Factor.- Reduction of Hypercholesterolemia.- Cholesterol and Women.- Age and Cholesterol.- Other Lipids as Risk Factors.- Fatty Acids.- Lipids and Thrombosis.- Education.- 14 Lipids: Epidemiology.- Possible Role of Lipids in Atherogenesis.- Lipids and Peripheral Vascular Disease: Epidemiological Studies.- Triglycerides.- Cholesterol.- HDL Cholesterol.- Apolipoproteins.- Essential Fatty Acids.- Lipid Peroxides.- Effect of Modifying Lipid Profiles on Peripheral Vascular Disease.- Peripheral Vascular Disease and Ischaemic Heart Disease.- 15 Blood Pressure.- Measurement of Peripheral Vascular Disease.- Relationship between Intermittent Claudication and Blood Pressure.- Lack of Foot Pulses and Brachial Pressure.- Low Systolic Pressure in the Foot and Brachial Pressure.- Causal Association?.- 16 Diabetes Mellitus.- Diabetes and Clinical Manifestations of Peripheral Vascular Disease.- Intermittent Claudication.- Pulse Deficits.- Lower Extremity Amputations.- Diabetes and Pathological Manifestations of Peripheral Vascular Disease.- Atheroma.- Medial Calcification.- Risk Factors for Peripheral Vascular Disease in Diabetes.- Conclusions.- Section IV: Social and Life Style Factors.- 17 Social Factors.- Social Factors and Health.- Social Deprivation and Peripheral Vascular Disease: Mortality and Hospital Discharges.- Measurement of Social Factors in Edinburgh Artery Study.- Statistical Analysis.- Ankle-Brachial Pressure Index and Social Class, Education, and Deprivation.- Individual Social Factors.- Combinations of Social Factors.- Effect of Cardiovascular Risk Factors.- Explaining Associations of Social Factors and Peripheral Vascular Disease.- 18 Diet and Alcohol.- Dietary Survey Methodology.- Range of Methods.- Food Frequency Questionnaires.- Edinburgh Artery Study and Diet: Methods.- Selection of Cases and Controls.- Dietary Analysis.- Diet in Cases vs. Controls.- Food Frequencies.- Nutrients and Energy.- Interpreting Dietary Differences.- 19 Personality.- Personality and Coronary Heart Disease.- Type A Behaviour Pattern.- Hostility.- Personality and Peripheral Vascular Disease.- Measurement of Personality in Edinburgh Artery Study.- Type A Behaviour Pattern (Bortner).- Personal Deviance (Foulds and Bedford).- The Disease-Prone Personality?.- 20 Exercise.- Exercise and Ischaemic Heart Disease.- Exercise and Peripheral Vascular Disease.- Edinburgh Artery Study: Exercise.- Interpreting Associations of Exercise and Cardiovascular Disease.- 21 Economics of Prevention and Treatment.- Economic Costs of Peripheral Vascular Disease.- The Role of Economic Evaluation.- Competing Interventions.- Primary Prevention.- Secondary Prevention.- New Technology.- Paying for Peripheral Vascular Care.- Priorities for Spending on Peripheral Vascular Disease.- Section V: Genetics, Development and Haemostasis.- 22 Maternal and Fetal Origins of Cardiovascular Disease.- Animal Studies.- Geographical Studies.- Follow-up Studies.- Fetal Growth.- Conclusion.- 23 Genetic Analysis.- Background to “Old” Genetic Analyses.- Vascular Disease and “Old” Genetic Analyses.- Background to “New” Genetic Analyses.- Vascular Disease and “New” Genetic Analyses.- 24 Fibrinogen.- Coagulability.- Ischaemic Heart Disease and Stroke.- Peripheral Vascular Disease.- Implications and Future Research.- 25 von Willebrand Factor, Beta-Thromboglobulin and Platelet Activation.- Role of Platelets in Atherosclerosis and Thrombosis.- Platelet Activation.- Endothelial Injury.- Platelets in Lesion Initiation and Thrombosis.- von Willebrand Factor.- Synthesis and Function of vWF.- Role of vWF in Thrombosis.- vWF and Vascular Disease.- Beta-Thromboglobulin.- Age, Sex, Smoking and ?-TG.- ?-TGand Coronary Heart Disease.- ?-TG and Peripheral and Cerebrovascular Disease.- 26 Blood Rheology.- Blood Rheology Factors in the Circulation.- Blood Rheology in Peripheral Vascular Disease.- Blood Rheology in Critical Limb Ischaemia.- Blood Rheology and Peripheral Arterial Graft Occlusion.- Rheological Therapy in Peripheral Vascular Disease.- Section VI: Natural History and Prevention.- 27 Natural History of Femoral Atheromatous Lesions.- Symptoms of the Lesion.- The Lesion “Under the Microscope”.- Plaque, Stenosis, and “Critical Stenosis”.- Effects of Stenosis.- Occlusion.- Regression of Atherosclerosis.- Progression of Atherosclerosis in Clinical Studies.- Predicting Progression of Disease.- 28 Prognosis of Intermittent Claudication.- Peripheral Vascular Disease: Another Manifestation of Atherosclerosis?.- Whitehall Study: Methods.- Intermittent Claudication in Whitehall Study.- Relation between Claudication and Ischaemic Heart Disease.- Intermittent Claudication and Coronary Risk Factors.- Intermittent Claudication and Subsequent Mortality.- Implications: Intermittent Claudication.- What is the Nature of Possible Claudication?.- 29 Factors Affecting Clinical Progression and Mortality.- Progression of Local Disease.- Factors Affecting Progression of Local Disease.- Overall Fate and Mortality of Claudicants.- Factors Affecting Overall Fate and Mortality of Claudicants.- Fate of the Amputee.- Conclusions.- 30 Asymptomatic Carotid Stenosis in Peripheral Vascular Disease Prevalence, Incidence and Natural History.- Non-Invasive Assessment.- Prevalence of Asymptomatic Carotid Stenosis.- Charing Cross Asymptomatic Carotid Study.- Incidence of Asymptomatic Carotid Stenosis.- Natural History of Patients with Asymptomatic Carotid Stenosis.- Future Research in Asymptomatic Carotid Disease.- 31 Prevention of Vascular Events in Claudicants.- Intermittent Claudication: Indicator of Generalised Atherosclerosis.- Value of Interventions in Claudicants.- Anti-thrombotic Treatment.- Swedish Ticlopidine Multicentre Study (STIMS).- Ketanserin Trial (PACK).- 32 Secondary Prevention of Ischaemic Heart Disease.- Fatty Fish.- Dietary Fibre.- Reduced Dietary Fat.- Exercise.- Drug Prophylaxis.- Need for Further Research.