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Lower extremity arterial disease assessed by ankle-brachial index in a middle-aged population of African Americans and whites: the Atherosclerosis Risk in Communities (ARIC) Study.
Am J Prev Med. 2005 Dec; 29(5 Suppl 1):42-9.AJ

Abstract

BACKGROUND

Lower extremity arterial disease (LEAD) is one of the most common manifestations of atherosclerosis. Its epidemiologic characteristics have not been well described, particularly in African Americans. Our purpose was to estimate the prevalence of LEAD and its associations with cardiovascular risk factors in a biracial population of men and women aged 45 to 64 years.

METHODS

We examined 15,173 African-American and white men and women who participated in the baseline examination (1987-1989) of the Atherosclerosis Risk in Communities (ARIC) Study. LEAD was defined by a resting ankle-brachial index (ABI), the ratio of ankle systolic blood pressure to brachial systolic pressure, of < or = 0.90. Cross-sectional analyses were used to determine the association of LEAD with cardiovascular risk factors.

RESULTS

The age-adjusted prevalence of ABI < or = 0.90 was 3.1% in African-American men, 4.4% in African-American women, 2.3% in white men, and 3.2% in white women. Cigarette smoking was the single most important risk factor for prevalent LEAD. The odds ratio estimate for LEAD in ever smokers versus never smokers was 6.6 (95% confidence interval [CI]=2.0-21.5) in African-American men, 2.3 (95% CI=1.5-3.5) in African-American women, 10.4 (95% CI=3.8-28.3) in white men, and 1.9 (95% CI=1.4-2.6) in white women, after adjustment for age, LDL cholesterol, hypertension, and diabetes. Prevalent LEAD was also associated with hypertension, diabetes, and higher concentrations of total cholesterol, triglycerides, LDL-cholesterol, and fibrinogen, and lower concentrations of HDL cholesterol, but the associations were not always significant across race/ethnic and gender groups. The associations of LEAD with plasma lipids were generally stronger in African Americans than whites.

CONCLUSIONS

The prevalence of LEAD appears to be higher in African Americans than whites. Elevations in traditional cardiovascular risk factors are associated with a higher prevalence of LEAD across race/ethnic and gender groups.

Authors+Show Affiliations

Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. zzheng@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16389125

Citation

Zheng, Zhi-Jie, et al. "Lower Extremity Arterial Disease Assessed By Ankle-brachial Index in a Middle-aged Population of African Americans and Whites: the Atherosclerosis Risk in Communities (ARIC) Study." American Journal of Preventive Medicine, vol. 29, no. 5 Suppl 1, 2005, pp. 42-9.
Zheng ZJ, Rosamond WD, Chambless LE, et al. Lower extremity arterial disease assessed by ankle-brachial index in a middle-aged population of African Americans and whites: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Prev Med. 2005;29(5 Suppl 1):42-9.
Zheng, Z. J., Rosamond, W. D., Chambless, L. E., Nieto, F. J., Barnes, R. W., Hutchinson, R. G., Tyroler, H. A., & Heiss, G. (2005). Lower extremity arterial disease assessed by ankle-brachial index in a middle-aged population of African Americans and whites: the Atherosclerosis Risk in Communities (ARIC) Study. American Journal of Preventive Medicine, 29(5 Suppl 1), 42-9.
Zheng ZJ, et al. Lower Extremity Arterial Disease Assessed By Ankle-brachial Index in a Middle-aged Population of African Americans and Whites: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Prev Med. 2005;29(5 Suppl 1):42-9. PubMed PMID: 16389125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lower extremity arterial disease assessed by ankle-brachial index in a middle-aged population of African Americans and whites: the Atherosclerosis Risk in Communities (ARIC) Study. AU - Zheng,Zhi-Jie, AU - Rosamond,Wayne D, AU - Chambless,Lloyd E, AU - Nieto,F Javier, AU - Barnes,Ralph W, AU - Hutchinson,Richard G, AU - Tyroler,Herman A, AU - Heiss,Gerardo, AU - ,, PY - 2004/12/18/received PY - 2005/07/08/revised PY - 2005/07/12/accepted PY - 2006/1/4/pubmed PY - 2006/6/21/medline PY - 2006/1/4/entrez SP - 42 EP - 9 JF - American journal of preventive medicine JO - Am J Prev Med VL - 29 IS - 5 Suppl 1 N2 - BACKGROUND: Lower extremity arterial disease (LEAD) is one of the most common manifestations of atherosclerosis. Its epidemiologic characteristics have not been well described, particularly in African Americans. Our purpose was to estimate the prevalence of LEAD and its associations with cardiovascular risk factors in a biracial population of men and women aged 45 to 64 years. METHODS: We examined 15,173 African-American and white men and women who participated in the baseline examination (1987-1989) of the Atherosclerosis Risk in Communities (ARIC) Study. LEAD was defined by a resting ankle-brachial index (ABI), the ratio of ankle systolic blood pressure to brachial systolic pressure, of < or = 0.90. Cross-sectional analyses were used to determine the association of LEAD with cardiovascular risk factors. RESULTS: The age-adjusted prevalence of ABI < or = 0.90 was 3.1% in African-American men, 4.4% in African-American women, 2.3% in white men, and 3.2% in white women. Cigarette smoking was the single most important risk factor for prevalent LEAD. The odds ratio estimate for LEAD in ever smokers versus never smokers was 6.6 (95% confidence interval [CI]=2.0-21.5) in African-American men, 2.3 (95% CI=1.5-3.5) in African-American women, 10.4 (95% CI=3.8-28.3) in white men, and 1.9 (95% CI=1.4-2.6) in white women, after adjustment for age, LDL cholesterol, hypertension, and diabetes. Prevalent LEAD was also associated with hypertension, diabetes, and higher concentrations of total cholesterol, triglycerides, LDL-cholesterol, and fibrinogen, and lower concentrations of HDL cholesterol, but the associations were not always significant across race/ethnic and gender groups. The associations of LEAD with plasma lipids were generally stronger in African Americans than whites. CONCLUSIONS: The prevalence of LEAD appears to be higher in African Americans than whites. Elevations in traditional cardiovascular risk factors are associated with a higher prevalence of LEAD across race/ethnic and gender groups. SN - 0749-3797 UR - https://www.unboundmedicine.com/medline/citation/16389125/Lower_extremity_arterial_disease_assessed_by_ankle_brachial_index_in_a_middle_aged_population_of_African_Americans_and_whites:_the_Atherosclerosis_Risk_in_Communities__ARIC__Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(05)00276-X DB - PRIME DP - Unbound Medicine ER -