What are the risk factors in peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Atherosclerosis is a systemic disease process. Accordingly, patients who present with claudication due to PAOD can be expected to have atherosclerosis elsewhere. A full assessment of the patient’s risk factors for vascular disease should therefore be performed. The risk factors for PAOD are the same as those for coronary artery disease (CAD) or cerebrovascular disease and include the following:

  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Family history
  • Sedentary lifestyle
  • Tobacco use
  • Chronic kidney disease

Smoking is the greatest of all the cardiovascular risk factors. The mechanism by which it causes or accentuates atherosclerosis is unknown. What is known is that the degree of damage is directly related to the amount of tobacco used. In a prospective cohort study of 39,825 women without cardiovascular disease, smoking was found to be a potent risk factor for symptomatic peripheral arterial disease, and cessation was found to reduce the risk. [4] Counseling patients on the importance of smoking cessation is paramount in PAOD management.

Low kidney function has been associated with the development of PAOD. In fact, a study conducted in Japan [5] found the prevalence of PAOD to be 17.2% among patients with estimated glomerular filtration rates (GFRs) lower than 60 mL/min/1.73 m2, compared with 7.0% in those with GFRs higher than 60 mL/min/1.73 m2. Advanced chronic kidney disease was found to be an independent risk factor for PAOD.


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