241 Particularities of the epidemiology of lower-extremities peripheral artery disease in Central Africa

Maëlenn Guerchet (1) , Victor Aboyans (1, 2) , Pascal M'Belesso , Alain Maxime Mouanga (1) , Johanna Salazar , Bébène Ndamba-Bandzouzi (1) , André Tabo , Philippe Lacroix (1, 2) , Pierre-Marie Preux (3, 4, 1)

1 NET - Neuroépidémiologie Tropicale
2 Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]
3 Laboratoire de Biostatistique et d'Informatique Médicale
4 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]

Background In the western countries, a high prevalence of lower-extremities peripheral artery disease (LE-PAD) is reported in the elderly. The epidemiological transition in the developing countries might also involve this affection, but data regarding LE-PAD in Sub-Saharan Africa are unknown. We sought to determine the prevalence and risk factors for LE-PAD in the general elder population in 2 Sub-Saharan African countries: Congo and Central African Republic. Methods We performed 2 cross-sectional studies in the populations aged >65 years in two representative districts of Brazzaville, Congo and Bangui, Central African Republic. Demographic data, as well as medical history, were collected along with clinical and biological data to determine the traditional cardiovascular disease risk factors. The ankle-brachial index (ABI) was used to define LE-PAD, when ABI <0.90. An ABI >1.40 was considered to define medial calcinosis (MC). Results Among the 997 participants (age 73.6+6.5 yrs, 40.7% males), 239 (24.0%) had LE-PAD, while 69 (6.9%) had MC. Adjusted for age, gender and study site, factors significantly associated with LE-PAD were hypertension (OR=1.75, 95%CI: 1.24-2.48, p=0.002) and daily alcohol consumption (OR=0.72, 95%CI: 0.53-0.98, p=0.04). A borderline association was found with a body-mass index >30kg/m2 (OR=1.56, 95%CI: 0.95-2.58, p=0.08). Of note, neither smoking nor diabetes were found as significant associated risk factors. Adjusted for age, gender and study site, factors significantly associated with MC were schooling (vs. no school education, OR=3.20, 95%CI: 1.69-6.04, p=0.0003) and hypertension (OR=0.38, 95%CI: 0.22-0.66, p=0.0006), while alcohol consumption (OR=0.63, 95%CI: 0.37-1.07, p=0.09) and heart rate (OR=1.23, 95%CI: 0.98-1.56, p=0.07) presented a borderline association. Conclusions In this first population study in Central Africa, we found a very high prevalence of LE-PAD in the elderly, and highlight particularities regarding the associated risk factors, different from data published in western countries.

Domaines: Santé publique et épidémiologie

Maëlenn Guerchet, Victor Aboyans, Pascal M'Belesso, Alain Maxime Mouanga, Johanna Salazar, et al.. 241 Particularities of the epidemiology of lower-extremities peripheral artery disease in Central Africa. Journées européennes de la Société Française de Cardiologie, Jan 2010, PARIS, France. pp.77, ⟨10.1016/S1878-6480(10)70243-3⟩. ⟨hal-01081185⟩