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Comparative Study
. 2009 Nov;50(5):1049-56.
doi: 10.1016/j.jvs.2009.05.061. Epub 2009 Jul 22.

Ethnicity and risk factors for change in the ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis

Matthew A Allison  1 , Mary Cushman, Cam Solomon, Victor Aboyans, Mary M McDermott, David C Goff Jr, Michael H Criqui
Affiliations
Comparative Study

Ethnicity and risk factors for change in the ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis

Matthew A Allison et al. J Vasc Surg. 2009 Nov.

Abstract

Background: The aim of this study was to determine the risk factors for conversion from a normal to either a low or high ankle-brachial index (ABI).

Methods: Participants in the Multi-Ethnic Study of Atherosclerosis who had two separate measurements of the ABI over a 3-year time period were assessed.

Results: At baseline, the mean age was 62 years and 50% were women, 28% African American, 12% Chinese, 22% Hispanic and 38% non-Hispanic White. Of the 5514 participants with a baseline ABI between 0.90 and 1.40, 89 (1.6%) had an ABI < or = 0.90 ("low ABI group") and 71 (1.3%) had an ABI > or = 1.40 ("high ABI group") 3 years later. On multivariable analysis, the odds for having progressed into the low ABI group were significantly increased for higher baseline age, hypertension, diabetes, greater pack-years of cigarette smoking, and homocysteine levels. The odds for progression into the high ABI group were increased for male gender and higher body mass index. Compared with non-Hispanic Whites, African Americans had a significantly higher odds for progression to the low ABI group (odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.29-3.88) while having a reduced odds for progression to the high ABI group (OR: 0.50, 95% CI: 0.24-1.00). Neither Chinese nor Hispanic ethnicity was significantly associated with progression to either ABI group.

Conclusions: The risk factors for progression to a low or high ABI were distinct and African Americans were at increased risk for progression to a low ABI but at decreased risk for progression into the high ABI group.

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Figures

Figure 1
Figure 1. Ethnicity and the Odds of Progressing into the Low ABI Group* over 3 Years: The Multi-Ethnic Study of Atherosclerosis
*Defined as an ABI ≤ 0.90 (non-Hispanic White Americans are the reference group). Model 1 – Adjusted for age and sex Model 2 – Adjusted for age, sex, body mass index, hypertension, diabetes, smoking and dyslipidemia Model 3 – Adjusted for age, sex, body mass index, hypertension, diabetes, smoking, dyslipidemia, new hypertension and new dyslipidemia Model 4 - Adjusted for age, sex, body mass index, hypertension, diabetes, smoking, dyslipidemia, family history of CVD new hypertension, new dyslipidemia and homocysteine
Figure 2
Figure 2. Race Specific Odds for Progressing into the High ABI Group* over 3 Years: The Multi-Ethnic Study of Atherosclerosis
*Defined as an ABI ≥ 1.40 (non-Hispanic White Americans are the reference group). Model 1 – Adjusted for age and sex Model 2 – Adjusted for age, sex, body mass index, hypertension, diabetes, smoking and dyslipidemia
See this image and copyright information in PMC

Comment in

  • Invited commentary.
    Timaran CH. Timaran CH. J Vasc Surg. 2009 Nov;50(5):1056. doi: 10.1016/j.jvs.2009.06.001. J Vasc Surg. 2009. PMID: 19878786 No abstract available.

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