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Relation of borderline peripheral arterial disease to cardiovascular disease risk.
Am J Cardiol 2006; 98(9):1226-30AJ

Abstract

Peripheral arterial disease (PAD) is a well-established risk factor for clinical cardiovascular disease (CVD). The impact of a low ankle-brachial index (ABI), higher than the generally recognized 0.9 cutpoint for PAD, on CVD risk is not well characterized. We analyzed data from the 1999 to 2002 National Health and Nutrition Examination Survey (n = 4,895), a nationally representative sample of United States adults, to determine the prevalence of PAD (ABI <0.90), borderline PAD (ABI 0.90 to 0.99), a low-normal ABI (1.00 to 1.09), and a normal ABI (1.10 to 1.29), and the association of these ABI levels with CVD. The prevalence of PAD, borderline PAD, a low-normal ABI, and a normal ABI was 5.0%, 8.7%, 27.8%, and 54.8%, respectively. After age, race/ethnicity, and gender adjustment, the odds ratios of a 10-year coronary heart disease (CHD) risk of >or=20%, CHD, stroke, and CVD were higher at lower ABI levels (each p trend <0.01). After additional adjustment for potential confounders, the odds ratios associated with a low-normal ABI, borderline PAD, and PAD, compared with those with a normal ABI, were 1.24 (95% confidence interval [CI] 0.91 to 1.70), 1.34 (95% CI 0.99 to 1.83), and 1.87 (95% CI 1.29 to 2.73), respectively (p trend <0.001) for CVD and 1.20 (95% CI 0.82 to 1.77), 1.45 (95% CI 0.80 to 2.63), and 2.02 (95% CI 1.20 to 3.39), respectively (p trend = 0.015) for a 10-year risk of CHD of >or=20%. In contrast, a trend was not present for CHD and stroke after multivariate adjustment. In conclusion, subjects with a low-normal ABI or with borderline PAD need screening for CVD risk factors, and interventions may be appropriate to prevent cardiovascular events.

Authors+Show Affiliations

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA. andy_menke@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17056334

Citation

Menke, Andy, et al. "Relation of Borderline Peripheral Arterial Disease to Cardiovascular Disease Risk." The American Journal of Cardiology, vol. 98, no. 9, 2006, pp. 1226-30.
Menke A, Muntner P, Wildman RP, et al. Relation of borderline peripheral arterial disease to cardiovascular disease risk. Am J Cardiol. 2006;98(9):1226-30.
Menke, A., Muntner, P., Wildman, R. P., Dreisbach, A. W., & Raggi, P. (2006). Relation of borderline peripheral arterial disease to cardiovascular disease risk. The American Journal of Cardiology, 98(9), pp. 1226-30.
Menke A, et al. Relation of Borderline Peripheral Arterial Disease to Cardiovascular Disease Risk. Am J Cardiol. 2006 Nov 1;98(9):1226-30. PubMed PMID: 17056334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relation of borderline peripheral arterial disease to cardiovascular disease risk. AU - Menke,Andy, AU - Muntner,Paul, AU - Wildman,Rachel P, AU - Dreisbach,Albert W, AU - Raggi,Paolo, Y1 - 2006/09/14/ PY - 2006/03/11/received PY - 2006/05/18/revised PY - 2006/05/23/accepted PY - 2006/10/24/pubmed PY - 2006/12/9/medline PY - 2006/10/24/entrez SP - 1226 EP - 30 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 98 IS - 9 N2 - Peripheral arterial disease (PAD) is a well-established risk factor for clinical cardiovascular disease (CVD). The impact of a low ankle-brachial index (ABI), higher than the generally recognized 0.9 cutpoint for PAD, on CVD risk is not well characterized. We analyzed data from the 1999 to 2002 National Health and Nutrition Examination Survey (n = 4,895), a nationally representative sample of United States adults, to determine the prevalence of PAD (ABI <0.90), borderline PAD (ABI 0.90 to 0.99), a low-normal ABI (1.00 to 1.09), and a normal ABI (1.10 to 1.29), and the association of these ABI levels with CVD. The prevalence of PAD, borderline PAD, a low-normal ABI, and a normal ABI was 5.0%, 8.7%, 27.8%, and 54.8%, respectively. After age, race/ethnicity, and gender adjustment, the odds ratios of a 10-year coronary heart disease (CHD) risk of >or=20%, CHD, stroke, and CVD were higher at lower ABI levels (each p trend <0.01). After additional adjustment for potential confounders, the odds ratios associated with a low-normal ABI, borderline PAD, and PAD, compared with those with a normal ABI, were 1.24 (95% confidence interval [CI] 0.91 to 1.70), 1.34 (95% CI 0.99 to 1.83), and 1.87 (95% CI 1.29 to 2.73), respectively (p trend <0.001) for CVD and 1.20 (95% CI 0.82 to 1.77), 1.45 (95% CI 0.80 to 2.63), and 2.02 (95% CI 1.20 to 3.39), respectively (p trend = 0.015) for a 10-year risk of CHD of >or=20%. In contrast, a trend was not present for CHD and stroke after multivariate adjustment. In conclusion, subjects with a low-normal ABI or with borderline PAD need screening for CVD risk factors, and interventions may be appropriate to prevent cardiovascular events. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/17056334/Relation_of_borderline_peripheral_arterial_disease_to_cardiovascular_disease_risk_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)01373-7 DB - PRIME DP - Unbound Medicine ER -