1
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
30
30
32
34
Indigo
Indigo
-
+
$ 404.6 $ 304.6
5 Pocket Jean - 30 / Indigo
$ 404.6 $ 304.6
30
30
32
34
Indigo
Indigo
-
+
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28)","#pibtn-icon-font-size":"16px","#continue-text":"Jatka ostoksia","#continue-display":"inline-block","#continue-width":"100px","#continue-height":"42px","#continue-effect-hover":"raise","#continue-font-size":"13px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(255, 255, 255)","#continue-background-color":"rgb(128, 83, 157)","#continue-background-color-hover":"rgb(240, 128, 80)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"5px","#checkout-text":"Kassa","#checkout-display":"block","#checkout-width":"100px","#checkout-height":"42px","#checkout-effect-hover":"raise","#checkout-font-size":"13px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 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{"#popup-showup-effect":"bounceDownIn","#popup-width":"850px","#popup-font-family":"News_Cycle","#popup-padding":"30px","#popup-background-color":"rgb(255, 255, 255)","#popup-border-width":"0px","#popup-border-color":"rgb(255, 255, 255)","#popup-border-radius":"5px","#product-title-display":"inline","#product-title-font-size":"16px","#product-title-font-weight":"700","#product-title-font-style":"normal","#product-title-text-decoration":"none solid rgb(0, 0, 0)","#product-title-text-align":"left","#product-title-color":"rgb(0, 0, 0)","#success-alert-text":"Product successfully added to your shopping cart","#success-alert-display":"block","#success-alert-font-size":"18px","#success-alert-font-weight":"700","#success-alert-font-style":"normal","#success-alert-text-decoration":"none solid rgb(40, 167, 69)","#success-alert-text-align":"left","#success-alert-color":"rgb(40, 167, 69)","#additional-quantity-text":"Quantity","#additional-subtotal-text":"Subtotal","#additional-total-text":" Total ","#additional-display":"block","#additional-font-size":"14px","#additional-font-weight":"400","#additional-font-style":"normal","#additional-text-decoration":"none solid rgb(0, 0, 0)","#additional-text-align":"left","#additional-color":"rgb(0, 0, 0)","#item-count-text-text":"There are {number} tems in your cart.","#item-count-text-display":"block","#item-count-text-font-size":"18px","#item-count-text-font-weight":"700","#item-count-text-font-style":"normal","#item-count-text-text-decoration":"none solid rgb(0, 0, 0)","#item-count-text-text-align":"left","#item-count-text-color":"rgb(0, 0, 0)","#cart-note-text":"Add a note for admin","#cart-note-display":"block","#cart-note-font-size":"14px","#cart-note-font-weight":"700","#cart-note-font-style":"normal","#cart-note-text-decoration":"none solid rgb(0, 0, 0)","#cart-note-text-align":"left","#cart-note-color":"rgb(0, 0, 0)","#continue-text":"CONTINUE SHOPPING","#continue-display":"inline-flex","#continue-width":"170px","#continue-height":"43px","#continue-font-size":"12px","#continue-font-weight":"400","#continue-font-style":"normal","#continue-text-decoration":"none solid rgb(255, 255, 255)","#continue-color":"rgb(255, 255, 255)","#continue-color-hover":"rgb(228, 228, 228)","#continue-background-color":"rgb(0, 0, 0)","#continue-background-color-hover":"rgb(0, 0, 0)","#continue-border-width":"0px","#continue-border-color":"rgb(0, 0, 0)","#continue-border-color-hover":"rgb(0, 0, 0)","#continue-border-radius":"0px","#checkout-text":"PROCEED TO CHECKOUT","#checkout-display":"inline-flex","#checkout-width":"169px","#checkout-height":"43px","#checkout-font-size":"12px","#checkout-font-weight":"400","#checkout-font-style":"normal","#checkout-text-decoration":"none solid rgb(255, 255, 255)","#checkout-color":"rgb(255, 255, 255)","#checkout-color-hover":"rgb(228, 228, 228)","#checkout-background-color":"rgb(0, 0, 0)","#checkout-background-color-hover":"rgb(0, 0, 0)","#checkout-border-width":"0px","#checkout-border-color":"rgb(0, 0, 0)","#checkout-border-color-hover":"rgb(0, 0, 0)","#checkout-border-radius":"0px","#tocartbtn-text":"GO TO CART","#tocartbtn-display":"none","#tocartbtn-width":"160px","#tocartbtn-height":"41px","#tocartbtn-font-size":"12px","#tocartbtn-font-weight":"400","#tocartbtn-font-style":"normal","#tocartbtn-text-decoration":"none solid rgb(255, 255, 255)","#tocartbtn-color":"rgb(255, 255, 255)","#tocartbtn-color-hover":"rgb(224, 224, 224)","#tocartbtn-background-color":"rgb(0, 0, 0)","#tocartbtn-background-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-width":"0px","#tocartbtn-border-color":"rgb(0, 0, 0)","#tocartbtn-border-color-hover":"rgb(0, 0, 0)","#tocartbtn-border-radius":"0px"}
{"#stickybar-display":"none","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(246, 247, 251)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(37, 37, 37)","#stickybar-buynow-background-color-hover":"rgb(37, 37, 37)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"15px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(242, 108, 79)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"2px"}
{"#stickybar-action":"goto_checkout","#stickybar-display":"flex","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"slide","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(17, 17, 17)","#stickybar-buynow-background-color-hover":"rgb(17, 17, 17)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(242, 108, 79)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(255, 255, 255)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"230px","#stickybar-buynow-height":"70px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 255, 255)","#stickybar-buynow-color":"rgb(255, 255, 255)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(0, 0, 0)","#stickybar-buynow-background-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(0, 0, 0)","#stickybar-buynow-border-color-hover":"rgb(0, 0, 0)","#stickybar-buynow-border-radius":"0px"}
{"#stickybar-display":"flex","#stickybar-action":"goto_checkout","#stickybar-font-family":"News_Cycle","#stickybar-background-color":"rgb(255, 255, 255)","#stickybar-height":"70px","#stickybar-position":"position_top","#stickybar-offset":"0px","#stickybar-display-type":"alwayshow","#stickybar-title-font-size":"16px","#stickybar-title-color":"rgb(0, 0, 0)","#stickybar-title-font-weight":"500","#stickybar-title-font-style":"normal","#stickybar-title-text-decoration":"none solid rgb(0, 0, 0)","#stickybar-buynow-text":"BUY NOW","#stickybar-buynow-width":"130px","#stickybar-buynow-height":"35px","#stickybar-buynow-font-size":"11px","#stickybar-buynow-effect-hover":"none","#stickybar-buynow-font-weight":"700","#stickybar-buynow-font-style":"normal","#stickybar-buynow-text-decoration":"none solid rgb(255, 254, 254)","#stickybar-buynow-color":"rgb(255, 254, 254)","#stickybar-buynow-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-background-color":"rgb(242, 108, 79)","#stickybar-buynow-background-color-hover":"rgb(244, 72, 35)","#stickybar-buynow-border-width":"0px","#stickybar-buynow-border-color":"rgb(255, 255, 255)","#stickybar-buynow-border-color-hover":"rgb(255, 255, 255)","#stickybar-buynow-border-radius":"0px"}
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Sepelvaltimotauti on yleistä tyypin 2 diabeetikoilla

Sepelvaltimotauti on yleistä tyypin 2 diabeetikoilla

Tyypin 2 diabetekseen liittyy korkea verensokeri. Mitä huonommassa hoitotasapainossa tyypin 2 diabetes on, sitä korkeammat verensokeriarvot yleensä ovat. Korkea verensokeri on harvoin itsessään akuuttien vaaratilanteiden aiheuttaja, mutta se aiheuttaa vuosien saatossa muutoksia elimistössä, ja luo riskitekijöitä liitännäissairauksille.

Liitännäissairaudet ovat seurausta vuosia jatkuneesta elimistöä rasittavista aineenvaihdunnallisista muutoksista. Aineenvaihdunnalliset muutokset luovat riskitekijöitä erilaisille vaaratilanteille ja komplikaatioille.

  Koholla olevan verensokerin lisäksi tyypin 2 diabetes aiheuttaa kroonista tulehdustilaa, johon liittyy rasvojen aineenvaihdunnan häiriöt, verisuonten rakenteelliset muutokset sekä insuliinin- ja välittäjäaineiden toiminnan häiriöt.

Erilaiset häiriöt ja muutokset aiheuttavat yhdessä vaurioita soluissa, kudoksissa ja elinjärjestelmissä. Lähes kaikilla diabeetikoilla on joitakin liitännäissairauksia ja suurin osa tyypin 2 diabeetikoista menehtyy juuri makrovaskulaarisiin (verisuoniperäiset) tauteihin, ennen eliniän odotetta.

Makrovaskulaariset muutokset alkavat jo ennen tyypin 2 diabeteksen diagnosoimista. Tilanteeseen ei ole kuitenkaan milloinkaan liian myöhäistä vaikuttaa. Hoitotilaa voidaan aina edistää ja komplikaatioriskiä pienentää pysyvillä elintapamuutoksilla.

Sepelvaltimotauti

Sepevaltimotauti on sydänsairaus ja yleinen kuolemaan johtava kansansairaus. Tyypin 2 diabeetikolla on muuhun väestöön verrattuna 2-4 kertaa korkeampi riski sairastua ja menehtyä sydänsairauteen. (2) Sepelvaltimotauti tarkoittaa sydänlihasten omien happea sekä ravinteita kuljettavien valtimoiden ahtautumista valtimokovettumataudin (ateroskleroosin) takia, joka aiheuttaa kroonista ja akuuttia sydänlihaksen hapenpuutetta eli iskemiaa. Se voi johtaa sydänlihaskuolioon eli sydäninfarktiin.


Diabeetikon sepelvaltimotaudin riskiä nostavat:

  1. Korkea verenpaine 
  2. Tupakointi 
  3. Vähäaktiivinen elämäntyyli 
  4. Sukurasitus 
  5. Hyperglykemia 
  6. Kohonneet veren rasva-arvot

Ennaltaehkäisy on elintärkeää

Diabeetikko, joka on saanut sydäninfarktin, on 90 % riski menehtyä seuraavan 8 vuoden aikana. Diabeetikolla, joka ei ole saanut sydäninfarktia, riski on 50 % (3).

Korkeat riskit kertovat sydänsairauksien ennaltaehkäisyn merkityksestä. Moni diabeteksen liitännäissairaus on ennaltaehkäistävissä, mutta i enää peruutettavissa.

Kun sydänsairaus on jo kehittynyt, mahdollisuus vaikuttaa siihen on huomattavasti pienempi.


Sepelvaltimotaudin ja sen vaikeusasteen paras ennustaja on HbA1c :n taso (pitkäaikaissokeri verikokeessa). Kuitenkaan pelkkä verensokerin hyvä hoitotasapaino ei merkittävästi vähennä sepelvaltimotaudin riskiä. (4)

Tyypin 2 diabeteksessa on useita muitakin riskitekijöitä, kuin vain koholla oleva sokeri. Riskit, kuten hyperinsulinemia (veren insuliinirunsaus), korkea verenpaine, dyslipidemia (rasva-aineenvaihdunnan häiriö) ja insuliiniresistenssi ovat myös sydänsairauksien riskitekijöitä. Nämä riskitekijät, ja diabeteksen esivaiheet, kuten kohonnut paastosokeri ja heikentynyt glukoosinsieto, nostavat sepelvaltimotaudin riskiä.

Lopeta tupakointi

Tupakointi kaksinkertaistaa makrovaskulaarisen taudin riskin ja lisää sydäninfarktin riskiä potilailla, joilla on todettu valtimokovettumatautia. Tupakointi nostaa ennenaikaisen kuoleman riskiä yksitoista kertaiseksi tyypin 2 diabeetikoilla verrattuna ei tupakoiviin ei-diabeetikoihin. (5) 

Verenpaine ja rasva-aineenvaihdunnan häiriöt altistavat komplikaatioille

Kun tyypin 2 diabeetikon verenpaine saadaan hyvään hoitotasapainoon, pienenee diabeteksen komplikaatioiden riski ja diabetekseen liittyvää kuolevuus noin 34 %. (6)

Tyypin 2 diabetes aiheuttaa veren rasva-aineenvaihdunnan häiriöitä, kuten HDL laskua, triglyseridien ja VLDL nousua. Nämä muutokset altistavat makrovaskulaarisen taudin kehittymiselle. Tyydyttyneen rasvan (eläinperäinen) saannin vähentäminen parantaa veren rasva-arvoja. Lisäksi dyslipidemiaa sairastavien potilaiden hoitaminen kolesterolilääkkeillä on selvästi vähentänyt makrovaskulaarisen taudin riskiä.

Tyypin 2 diabetes ja sen mukana olevat aineenvaihdunnalliset muutokset altistavat voimakkaasti trombien (veritulppa) syntymiselle. Diabeetikoiden trombiriskiä voi vähentää merkittävästi painoa pudottamalla, hoitamalla veren rasva-arvot ja verensokerit kuntoon.

Kroonisen tulehdustilan merkkiaine ja yksi parhaista sydäninfarktin ennustajista on koholla oleva CRP. Sen lasku lääkityksellä ja elintapahoidoilla vähentää infarktin riskiä merkittävästi.

ASO-tauti (atherosclerosis obliterans)

ASO-tauti tarkoittaa jalkojen valtimoiden tukkeutumista ateroskleroosin (valtimokovettumataudin) takia. Samalla tavalla kuten sepelvaltimotauti, aiheuttaa se hapenpuutetta jalkojen lihaksissa, kun kudokset ei virtaa riittävää määrää verta. ASO-tautia sairastavien potilaiden kuolleisuus on 2-4 kertaa suurempi verrattuna ihmisiin ilman ASO-tautia. (7)

ASO-tauti voi aiheuttaa myös jalan kipeytymistä kävelyn (tai muun rasituksen) yhteydessä. Kiputiloja kutsutaan claudicatio-oireiksi ja niitä todetaan 75% :lla diabeetikoista.

ASO-taudin riskitekijät:

  1. Dyslipidemia eli koholla olevat veren rasva-arvot 
  2. Tupakointi 
  3. Ikääntyminen 
  4. Munuaissairaus 
  5. Korkea verenpaine 
ASO-taudin potilaista 90 % :lla on sepelvaltimotauti ja 80 % :lla kaulavaltimoiden ahtauma, mikä on hyvä esimerkki siitä, että diabeteksen aiheuttamat ongelmat vaikuttavat koko elimistöön samaan aikaan.

Claudicatio-potilaista 1-3 % tarvitsee raajan amputaation 5 vuoden sisällä ja 5 vuoden sisällä amputaatiosta kuolleisuus claudicatio-potilailla on lähellä 30 %.

Liikunta on tutkitusti tehokkain hoitomuoto kyseiseen sairauteen.

ASO-taudin vaiheet:

  1. Asymptomaattinen tauti (oireeton vaihe), diagnosoitava vain ABI-mittauksella (valtimotaudin riskin arviointi) 
  2. Claudicatio intermittens (katkokävely, kiputilat) 
  3. Leposärky 
  4. Nekroosi (solujen kuolema), haavaumat 
ASO-taudin riskiä pienennetään vähentämällä kaikkia riskitekijöitä.
 

Aivo- ja kaulavaltimoiden tauti

Aivo- ja kaulavaltimoiden tauti vaikuttaa aivojen toimintaan ja saattaa aiheuttaa aivohalvausta ja muistisairauksia. Syntymekanismit ovat samat kuten muissa valtimotaudeissa: ateroskleroottiset muutokset verisuonien seinissä vähentävät veren virtausta aivoihin, jolloin aivojen hapensaanti vähenee. Tähän kuuluvat esimerkiksi TIA-kohtaukset (äkillinen, lyhytkestoinen verenkiertohäiriö), aivoinfarkti/-halvaus ja verisuoniperäinen dementia.

Diabetespotilailla on kaksinkertainen riski sairastua kaula- ja aivovaltimoiden tautiin ja saada aivoinfarkti kuin ei-diabeetikoilla.

Aivo- ja kaulavaltimoiden taudin riskitekijät:

  1. Tupakointi 
  2. Korkea ruoan jälkeinen sokeri 
  3. Korkea verenpaine (60 % tapauksista hoitamatta verenpainetaudin takia) 
  4. Korkea LDL

Yhteenveto ja call to action

Isojen valtimoiden sairaudet ovat pelätyimpiä tyypin 2 diabeteksen seurauksia. Pelkän verensokerin ja diabeteksen hoitaminen ei riitä näiden välttämiseksi. Verisuonimuutokset sekä patologiset prosessit alkavat jo vuosia ennen tyypin 2 diabeteksen diagnosoimista ja johtuvat riskitekijöiden yhteisvaikutuksesta. Paras keino välttää komplikaatiot on ennaltaehkäistä tyypin 2 diabetesta, mutta koskaan ei ole liian myöhäistä pienentää riskejä. Oikealla ruokavaliolla, painoa pudottamalla, liikkumalla sekä oikealla lääkityksellä voidaan pitkälle edenneissä sairauksissa pidentää elinikää ja parantaa elämänlaatua merkittävästi.

Tarvitsetko apua elintapamuutokseen? Tutustu Diabetesvalmennukseemme täällä!

Lähdeluettelo:

Lääketieteen sanasto. Kustannus Oy Duodecim. 

  • Gilpin E, Ricou F, et al. Factors associated with recurrent myocardial infarction within one year after acute myocardial infarction. Am Heart J 1991;121:457–463. 
  • Haffner SM, Lehto S, et al. Mortality from coronary artery disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339:229–234. 
  • Herlitz J, Malmberg K, et al. Mortality and morbidity during a five year follow up of diabetics with myocardial infarction. Acta Med Scand 1988;224:31–38. 
  • Hansson L, Zanchetti A, Carruthers SG. Effects of intensive blood pressure lowering and low dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet 1998;351:1755–1762. 
  • Uusitupa M, et al. The relationship of cardiovascular risk factors to the prevalence of coronary heart disease in newly diagnosed type 2 diabetes. Diabetolologia 1985;28:653–659. 
  • Criqui MH, Langer RD, Fronek A. Mortality over a period of 10 years in patients with peripheral vascular disease. N Engl J Med 1992;326:381–386.