• Open Access

Prevalence of peripheral arterial disease: persistence of excess risk in former smokers


Department of Public Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009. Fax: (08) 9266 3636; e-mail: bfowler@curtin.edu.au


Objective: To determine the age-standardised prevalence of peripheral arterial disease (PAD) and associated risk factors, particularly smoking.

Method: Design: Cross-sectional survey of a randomly selected population. Setting: Metropolitan area of Perth, Western Australia. Participants: Men aged between 65–83 years.

Results: The adjusted response fraction was 77.2%. Of 4,470 men assessed, 744 were identified as having PAD by the Edinburgh Claudication Questionnaire and/or the ankle-brachial index of systolic blood pressure, yielding an age-standardised prevalence of PAD of 15.6% (95% confidence intervals (CI): 14.5%, 16.6%). The main risk factors identified in univariate analyses were increasing age, smoking — current (OR=3.9, 95% CI 2.9–5.1) or former (OR=2.0, 95% CI 1.6–2.4), physical inactivity (OR=1.4, 95% CI 1.2–1.7), a history of angina (OR=2.2, 95% CI 1.8–2.7) and diabetes mellitus (OR=2.1, 95% CI 1.7–2.6). The multivariate analysis showed that the highest relative risk associated with PAD was current smoking of 25 or more cigarettes daily (OR=7.3, 95% CI 4.2–12.8). In this population, 32% of PAD was attributable to current smoking and a further 40% was attributable to past smoking by men who did not smoke currently.

Conclusions: This large observational study shows that PAD is relatively common in older, urban Australian men. In contrast with its relationship to coronary disease and stroke, previous smoking appears to have a long legacy of increased risk of PAD.

Implications: This research emphasises the importance of smoking as a preventable cause of PAD.