Journal List > J Korean Surg Soc > v.78(5) > 1011111

TOOLS
Kim, Jeon, Cho, Kong, Jung, Park, Cho, Kim, Shin, Ahn, Cho, Kim, Lee, Hur, Choi, Choe, and Hong: Prevalence and Characteristics of Major Vascular Diseases of Elderly Men in the Incheon Area
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 78(5): 305-313.

Published online: 10 May 2010

DOI: https://doi.org/10.4174/jkss.2010.78.5.305

Prevalence and Characteristics of Major Vascular Diseases of Elderly Men in the Incheon Area

Jang Yong Kim, M.D., Ph.D., Yong Sun Jeon, M.D., Ph.D.1, Soon Gu Cho, M.D., Ph.D.1, Eunmi Kong, RT, Ji-eun Jung, RT, Shin Goo Park, M.D., Ph.D.2, Jae-Sung Cho, M.D.3, Kyung Rae Kim, M.D., Ph.D., Seok-Hwan Shin, M.D., Ph.D., Seung-Ik Ahn, M.D., Ph.D., Young Up Cho, M.D., Ph.D., Sei Joong Kim, M.D., Ph.D., Keon-Young Lee, M.D., Ph.D., Yoon-Seok Hur, M.D., Ph.D., Sun Keun Choi, M.D., Ph.D., Yun-Mee Choe, M.D., Ph.D., Kee Chun Hong, M.D., Ph.D.

Department of Surgery, Inha University School of Medicine, Incheon, Korea.

1Department of Radiology, Inha University School of Medicine, Incheon, Korea.

2Department of Preventive Medicine, Inha University School of Medicine, Incheon, Korea.

3Division of Vascular Surgery, Department of Surgery, The University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Corresponding author (keechong@inha.ac.kr)

Received 16 December 2009       Accepted 18 January 2010

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

As Korea is an aging society (WHO classification) and projected to be an aged society in 10 years, peripheral vascular diseases (PVD) in the elderly population has emerged as an important social and medical issue. But their prevalence was rarely reported in Korea. The purpose of this study is to define the prevalence of carotid artery stenosis (CAS), abdominal aortic aneurysm (AAA), and peripheral arterial occlusive disease (PAOD) of lower limb in the Incheon area.

Methods

Elderly men (≥65 years) were referred randomly from the Incheon Federation of Korean Senior Citizens' Association (from Nov 2008 to Sep 2009) to Inha Univeristy Hospital, Incheon, Korea for a PVD screening program. The subjects were screened for CAS and AAA by duplex. CAS was defined as ≥50% internal CAS and AAA as ≥3 cm aortic diameter in minor axis. PAOD of lower limb was screened by measurement of ankle brachial index (ABI); ABI of ≤0.9 was considered abnormal.

Results

1150 subjects were screened including 103 octogenarians (9.0%). Mean age was 72.3±0.2 years. Combined conditions were hypertension (54.3%), diabetes mellitus (25.2%), coronary artery disease (15.6%), dyslipidemia (18.9%), obesity (31.1%) and smoking history (71.7%). CAS was detected in 7.7% (89/1,150) subjects. Thirty-three (2.9%) were diagnosed with AAA. PAOD was detected in 50 subjects (4.4%).

Conclusion

Prevalence of PVD in Korea is not lower compared to that of western countries, especially the USA and the UK. A nationwide program for timely detection and treatment for PVD should be developed.

Keywords: Screening, Prevalence, Carotid artery stenosis, Abdominal aortic aneurysm, Peripheral vascular disease

Figures and Tables

Fig. 1
Diagram indicating overlap in vascular diseases affecting different territories. *CAS = carotid artery stenosis; †AAA = abdominal aortic aneurysm; ‡PAOD = peripheral arterial occlusive disease of lower limb.
jkss-78-305-g001
Fig. 2
Treated volumes of abdominal aortic aneurysm (AAA) in Korea from 2004 to 2008. *EVAR = endovascular aneurysm repair; †AAA OR = abdominal aortic aneurysm open repair.
jkss-78-305-g002
Fig. 3
Treated volumes of carotid artery stenosis in Korea from 2004 to 2008.
jkss-78-305-g003
Table 1
Prevalences of major vascular diseases for elderly men in previous reports
jkss-78-305-i001

*CAS = carotid artery stenosis; †RS = retrospective study; ‡CSS = cross sectional study; §AAA = abdominal aortic aneurysm; ∥RCS = randomized controlled study; PAOD = peripheral arterial occlusive disease in lower limbs; **ABI = ankle brachial index.

Table 2
Characteristics of study subjects, Nov 2008~Sep 2009
jkss-78-305-i002

*PVD = peripheral vascular disease; †BMI = body mass index.

Table 3
Prevalences of carotid artery stenosis by duplex scan
jkss-78-305-i003

*ICA = carotid artery stenosis; †PSV = peak systolic velocity; ‡CCA = common carotid artery.

Table 4
Odds ratios for risk factors for carotid artery stenosis (≥50%, ICA PSV*≥125 cm/s)
jkss-78-305-i004

*ICA PSV = internal carotid artery peak systolic velocity; †BMI = body mass index.

Table 5
Prevalences of abdominal aortic aneurysm (AAA) by duplex scan
jkss-78-305-i005
Table 6
Odds ratios for risk factors for abdominal aortic aneurysm ≥3 cm in diameter
jkss-78-305-i006

*BMI = body mass index.

Table 7
Prevalences of peripheral arterial occlusive disease of lower limb by ankle brachial index
jkss-78-305-i007
Table 8
Odds ratios for risk factors for peripheral arterial occlusive disease of lower limb (ABI*≤0.9)
jkss-78-305-i008

ABI* = ankle brachial index; BMI† = body mass index.

Table 9
Comparison of populations and treated abdominal aortic aneurysm (AAA) volumes among Korea, Japan and USA
jkss-78-305-i009
Table 10
Estimation of prevalences of carotid artery stenosis (≥50%) for elderly men in Incheon and Korea according to age
jkss-78-305-i010
Table 11
Estimation of prevalences of abdominal aortic aneurysm (AAA) for elderly men in Incheon and Korea according to age
jkss-78-305-i011
Table 12
Estimation of prevalences of peripheral arterial occlusive disease for elderly men in Incheon and Korea according to age
jkss-78-305-i012

References

1. Criqui MH, Fronek A, Barrett-Connor E, Klauber MR, Gabriel S, Goodman D. The prevalence of peripheral arterial disease in a defined population. Circulation. 1985. 71:510–515.
2. Hiatt WR, Hoag S, Hamman RF. Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study. Circulation. 1995. 91:1472–1479.
3. Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation. 2004. 110:738–743.
4. 2007 Statistics for Elderly Population. 2007. Statistics Korea:
5. Anderson CS, Linto J, Stewart-Wynne EG. A population-based assessment of the impact and burden of caregiving for long-term stroke survivors. Stroke. 1995. 26:843–849.
6. Fleming C, Whitlock EP, Beil TL, Lederle FA. Screening for abdominal aortic aneurysm: a best-evidence systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2005. 142:203–211.
7. Cosford PA, Leng GC. Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev. 2007. CD002945.
8. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007. 45:Suppl S. S5–S67.
9. Park KC, Kim DI, Lee SJ, Lee BB, Lee CH, Kim DY, et al. Prevalence of asymptomatic carotid atherosclerosis in Korea. J Korean Soc Vasc Surg. 1999. 15:228–233.
10. Lavenson GS Jr, Pantera RL, Garza RM, Neff T, Rothwell SD, Cisneros J. Development and implementation of a rapid, accurate, and cost-effective protocol for national stroke prevention screening. Am J Surg. 2004. 188:638–643.
11. Rockman CB, Jacobowitz GR, Gagne PJ, Adelman MA, Lamparello PJ, Landis R, et al. Focused screening for occult carotid artery disease: patients with known heart disease are at high risk. J Vasc Surg. 2004. 39:44–51.
12. de Weerd M, Greving JP, de Jong AW, Buskens E, Bots ML. Prevalence of asymptomatic carotid artery stenosis according to age and sex: systematic review and metaregression analysis. Stroke. 2009. 40:1105–1113.
13. Lederle FA, Johnson GR, Wilson SE. Abdominal aortic aneurysm in women. J Vasc Surg. 2001. 34:122–126.
14. Lindholt JS, Henneberg EW, Fasting H, Juul S. Hospital based screening of 65-73 year old men for abdominal aortic aneurysms in the county of Viborg, Denmark. J Med Screen. 1996. 3:43–46.
15. Jamrozik K, Norman PE, Spencer CA, Parsons RW, Tuohy R, Lawrence-Brown MM, et al. Screening for abdominal aortic aneurysm: lessons from a population-based study. Med J Aust. 2000. 173:345–350.
16. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002. 360:1531–1539.
17. Shin IH, Im HW. Calculation of Sample Size by Excel in Clinical Research. 2009. 1st ed. Seoul: Gunja.
18. Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, et al. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999. 30:1751–1758.
19. Strandness DE Jr. Duplex Scanning in Vascular Disorders. 1993. 2nd ed. New York: Raven Press.
20. Winkelaar GB, Chen JC, Salvian AJ, Taylor DC, Teal PA, Hsiang YN. New duplex ultrasound scan criteria for managing symptomatic 50% or greater carotid stenosis. J Vasc Surg. 1999. 29:986–994.
21. Ahn YO, Yu KY, Park BJ, Chun JP. Statistics in Clinical Medicine. 2005. Seoul: SNUpress.
22. Lee ES, Pickett E, Hedayati N, Dawson DL, Pevec WC. Implementation of an aortic screening program in clinical practice: implications for the Screen For Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act. J Vasc Surg. 2009. 49:1107–1111.
23. Kim YW, Min SK, Koh YB, Kim SN, Park JS, Moon IS, et al. Report of nation-wide questionnaire survey for abdominal aortic aneurysm treatment in Korea. J Korean Soc Vasc Surg. 2005. 21:10–15.
24. Hwang ES, Lee IB, Choi CS. Health insurance, number for current treatment of abdominal aortic aneurysm in Korea (2004-2008). Inha Treatment. 2009. 04. 02. No. 147.
25. Obitsu Y. The current management and experience for AAA repair in Japan. 2009. In : 49th Annual Spring Meeting; 2009 Apr 10 - 11; The Korean Society of Vascular Surgery.
26. Giles KA, Pomposelli F, Hamdan A, Wyers M, Jhaveri A, Schermerhorn ML. Decrease in total aneurysm-related deaths in the era of endovascular aneurysm repair. J Vasc Surg. 2009. 49:543–550.
27. Hwang ES, Lee IB, Choi CS. Health insurance, number for current treatment of carotid artery stenosis in Korea (2004-2008). Inha Treatment. 2009. 06. 22. No. 259.
28. Wilmink AB, Forshaw M, Quick CR, Hubbard CS, Day NE. Accuracy of serial screening for abdominal aortic aneurysms by ultrasound. J Med Screen. 2002. 9:125–127.
29. Lederle FA, Wilson SE, Johnson GR, Reinke DB, Littooy FN, Acher CW, et al. Variability in measurement of abdominal aortic aneurysms. Abdominal Aortic Aneurysm Detection and Management Veterans Administration Cooperative Study Group. J Vasc Surg. 1995. 21:945–952.
TOOLS
Similar articles