Based on prospective epidemiological studies, tentative conclusions concerning the place of occlusive peripheral artery disease ( OPAD ) in general practice are presented. For men aged 35-64 the 5-year incidence of OPAD was found to be 76%, i.e. 3 times higher than that of intermittent claudication. In a high percentage of cases new occurrences of OPAD were predictable by the risk profile at entry. Men with 3 risk factors had an incidence of 114% compared to 20% in those free of risk at entry. A comparative 11-year follow-up of 273 men with OPAD and 273 age-matched, randomly selected controls without OPAD , revealed a moderate incidence of local complications (3% amputations) but an impressive excess mortality of 33% vs 11%, mainly due to coronary heart disease. The high correlation between the risk profile on the one hand and morbidity/mortality on the other emphasizes the need for action against risk factors. The efficacy of measures for the improvement of the risk profile and the reduction of cardiovascular mortality is discussed on the basis of the so-called " Mister Fit Study".
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