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International Journal of Vascular Medicine
Volume 2014, Article ID 643589, 8 pages
Research Article

Prevalence, Correlates, and Prognosis of Peripheral Artery Disease in Rural Ecuador—Rationale, Protocol, and Phase I Results of a Population-Based Survey: An Atahualpa Project-Ancillary Study

1School of Medicine, Universidad Espíritu Santo-Ecuador, Guayaquil, Ecuador
2Air Center 3542, P.O. Box 522970, Miami, Fl 33152-2970, USA
3School of Medicine, Stony Brook University, Health Sciences Center, L-4 Room 158, Stony Brook, NY 11794, USA
4Gastroenterology Department, Vanderbilt University, Nashville, TN, USA
5Sleep Disorders Center, Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL 32224, USA
6Community Center, Villa Club Etapa Cosmos Mz 15 Villa 42, Atahualpa, Daule, Guayas, Ecuador
7Cardiovascular Division, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8086, St. Louis, MO 63110, USA

Received 23 May 2014; Accepted 28 July 2014; Published 21 September 2014

Academic Editor: Robert M. Schainfeld

Copyright © 2014 Oscar H. Del Brutto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Little is known on the prevalence of peripheral artery disease (PAD) in developing countries. Study design. Population-based study in Atahualpa. In Phase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. In Phase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. In Phase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes. Results. During Phase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). A poor cardiovascular health status was noticed in 464 (70%) persons of which 27 (4%) had a stroke and 14 (2%) had ischemic heart disease. Forty-four subjects (7%) had suspected symptomatic PAD and 170 (26%) had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD. Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region.