Is Arterial Disease a Risk Factor for Chronic Leg Ulceration?

Abstract

Objective: To compare extent of arterial disease in chronic leg ulcer patients and controls without leg ulcer. Design: Case control study. Setting: Lothian and Forth Valley Leg Ulcer Study (patients) and Edinburgh Artery Study (controls). Patients: 331 leg ulcer patients aged 55–74 years identified in a population survey and 331 age- and sex-matched population controls. Interventions: Questionnaires which included cardiovascular history. Measurement of ankle and brachial systolic pressures. Main outcome measures: History of intermittent claudication, previous heart attack, hypertension, diabetes mellitus. Lower ankle brachial pressure index (ABPI) of either leg. Results: Frequencies of intermittent claudication, previous heart attack, hypertension and diabetes mellitus were very similar between the study groups. Mean (SE) ABPI was 1.1 (0.01) in patients and 1.0 (0.01) in controls ( p < 0.001), although the difference was due partly to variation in measurement techniques. Conclusions: Arterial disease was not found more frequently in patients than in controls, suggesting that arterial disease is not a risk factor for chronic leg ulceration, but clarification is required from other studies.