Atherosclerotic peripheral arterial disease in blacks--an established problem.

Records of black (predominantly Zulu), Indian and white patients admitted to hospital for elective evaluation of chronic peripheral arterial disease over a 2-year interval were examined. The commonest lesion encountered in all three groups was atherosclerosis, although arteritis occurred more frequently in blacks. While atherosclerotic occlusive disease of the lower extremities showed minor differences in distribution in the three groups, aneurysmal disease of the aorta was more frequent in the white than Indian and black groups. Cerebrovascular occlusive disease was also less prevalent among blacks. Age and sex distribution was similar. In a subset of patients, matched for age, with aorto-iliac occlusive disease blacks had a statistically significantly lower incidence of ischaemic heart disease, cerebrovascular disease and hypertension than whites or Indians; and smoked less. Diabetes had a significantly higher incidence in Indians. Within the same group of patients, blacks tended to present at a more advanced stage in the natural history of the disease. However, early and medium-term results of aortobifemoral bypass are not significantly different from those in whites or Indians. Atherosclerosis, contrary to popular belief, is a well-established clinical problem in the black population in Natal.