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. 2014 Jun;21(6):704-11.
doi: 10.1177/2047487312452968. Epub 2012 Jun 27.

Peripheral arterial disease, prevalence and cumulative risk factor profile analysis

Luis H Eraso  1 , Eri Fukaya  2 , Emile R Mohler 3rd  2 , Dawei Xie  3 , Daohang Sha  3 , Jeffrey S Berger  4
Affiliations

Peripheral arterial disease, prevalence and cumulative risk factor profile analysis

Luis H Eraso et al. Eur J Prev Cardiol. 2014 Jun.

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.

Keywords: NHANES; Peripheral arterial disease; risk assessment; traditional cardiovascular risk factors.

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Figures

Figure 1
Figure 1
Relative odds of peripheral arterial disease (PAD) based on the number of clinical risk factors (NHANES 1999–2002). Odds ratios (95% confidence intervals) and trend probabilities of PAD based on an increased number of cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, current smoking and chronic kidney disease [estimated glomerular filtration rate ≤60]) are presented.
Figure 2
Figure 2
Subgroup analysis of the relative odds of peripheral arterial disease (PAD) based on the number of clinical risk factors (NHANES 1999–2004). Odds ratios and trend probabilities of PAD among age, gender, race/ethnicity groups based on an increased number of cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, current smoking and chronic kidney disease [estimated glomerular filtration rate ≤60]) are presented. NH, non-Hispanic; MA, Mexican-American. *Significant associations p ≤0.05.
Figure 3
Figure 3
Relative odds of peripheral arterial disease (PAD) based on the number of clinical risk factors (NHANES 2003–2004). Odds ratio (95% confidence intervals) and trend probability of PAD based on an increased number of cardiovascular risk factors (hypertension, diabetes, hypercholesterolemia, current smoking and chronic kidney disease [estimated glomerular filtration rate ≤60]).
See this image and copyright information in PMC

References

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