A new study shows that four major risk factors – hypertension, diabetes, smoking and hyperlipidemia – are the leading causes of most peripheral arterial disease. The study was led by Dr. Michel Joosten. He explained, “Controlling these four risk factors can prevent up to 75 percent of peripheral artery disease. Public health should prioritize the prevention of these four risk factors.” This applies especially to hypertension and smoking, he said. “In terms of peripheral artery disease, the risks associated with smoking last a long time, so it’s important to stay away from cigarettes. And as opposed to hypertension, once diagnosed, the dangers it poses become apparent very quickly. These four risk factors are independent and complex, according to Joosten. If any one of these risk factors is present, it’s important to avoid the others, because adding any of the others increases risk.” ”We don’t have to worry too much about other risk factors that are not identified, or genetic factors that cannot be verified in a clinical context. We only need to focus on these four known risk factors.” Currently, Joosten and his colleagues measured experimental data from the HealthProfessionalsFollow-up study, which followed 51,529 men aged 40 to 75 years at baseline in 1986. They completed a questionnaire every two years about their disease history, which included intermittent claudication and lifestyle. Men with a family history of cardiovascular disease or a diagnosis of cardiovascular disease (acute myocardial infarction, stroke, coronary artery bypass grafting, coronary angioplasty, and intermittent claudication) were excluded. During a mean follow-up of 24 years, a total of 537 cases developed peripheral arterial disease. Smoking, hypertension, hyperlipidemia, and type 2 diabetes were evident, and when adjusted for the other three risk factors, the risk factors for peripheral artery disease were found to be independent of each other. The incidence of peripheral arterial disease was correlated with the number of risk factors The multivariate adjusted risk ratio for each risk factor was 2.06. The risk ratio for men without exposure to any of the risk factors was 0.23 compared to other men in the cohort. 96% of cases with peripheral arterial disease had at least one risk factor present at the time of diagnosis of peripheral arterial disease. The exact annual incidence of peripheral artery disease among men with four risk factors was 3.5 per 1,000, and the researchers say the incidence has been underestimated due to the tightening of the new definition of peripheral artery disease diagnosis. They noted that although these four major risk factors have the same impact on other cardiovascular diseases, there are still important differences here. For example, 80% of patients with coronary artery disease have at least one of these risk factors, compared with more than 95% of patients with severe peripheral artery disease. In addition to this, the effect of smoking on peripheral artery disease is more than two to three times that of coronary artery disease, and the risk of peripheral artery disease is not reduced to baseline after quitting smoking, whereas it is reduced to baseline for coronary artery disease and stroke.