Peripheral arterial disease, prevalence and cumulative risk factor profile analysis

Abstract Background The primary aim of the present study was to determine the cumulative effect of a set of peripheral artery disease (PAD) risk factors among age, gender and race/ethnicity groups in the United States. Methods We examined data from a nationally representative sample of the US popula...

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Bibliographic Details
Published in:European journal of preventive cardiology 2014-06, Vol.21 (6), p.704-711
Main Authors: Eraso, Luis H, Fukaya, Eri, Mohler, Emile R, Xie, Dawei, Sha, Daohang, Berger, Jeffrey S
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ankle Brachial Index
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular Diseases - epidemiology
Cross-Sectional Studies
Diabetes Mellitus - epidemiology
Diabetes. Impaired glucose tolerance
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Female
Heart
Humans
Hypercholesterolemia - epidemiology
Hypertension - epidemiology
Male
Medical sciences
Middle Aged
Peripheral Arterial Disease - epidemiology
Prevalence
Renal Insufficiency, Chronic - epidemiology
Risk Factors
Sickness Impact Profile
Smoking - epidemiology
United States - epidemiology
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Summary:Abstract Background The primary aim of the present study was to determine the cumulative effect of a set of peripheral artery disease (PAD) risk factors among age, gender and race/ethnicity groups in the United States. Methods We examined data from a nationally representative sample of the US population (National Health and Nutrition Examination Survey [NHANES], 1999–2004). A total of 7058 subjects 40 years or older that completed the interview, medical examination and had ankle–brachial index (ABI) measurements were included in this study. Results The age- and sex-standardized prevalence of PAD was 4.6 % (standard error [SE] 0.3%).The highest prevalence of PAD was observed among elderly, non-Hispanic Blacks and women. In a multivariable age-, gender- and race/ethnicity-adjusted model hypertension, diabetes, chronic kidney disease, and smoking were retained as PAD risk factors (p ≤ 0.05 for each). The odds of PAD increased with each additional risk factor present from a non-significant 1.5-fold increase (O.R 1.5, 95% confidence interval [CI] 0.9–2.6) in the presence of one risk factor, to more than ten-fold (OR 10.2, 95% CI 6.4–16.3) in the presence of three or more risk factors. In stratified analysis, non-Hispanic Blacks (OR 14.7, 95% CI 2.1–104.1) and women (OR 18.6, 95% CI 7.1–48.7) were particularly sensitive to this cumulative effect. Conclusion In a large nationally representative sample, an aggregate set of risk factors that included diabetes mellitus, chronic kidney disease, hypertension and smoking significantly increase the likelihood of prevalent PAD. A cumulative risk factor analysis highlights important susceptibility differences among different population groups and provides additional evidence to redefine screening strategies in PAD.
ISSN:2047-4873
2047-4881
DOI:10.1177/2047487312452968