BACKGROUND: An ankle-brachial index (ABI) of less than 0.9 is a noninvasive measure of lower extremity arterial disease and a predictor of cardiovascular events. Little information is available on longitudinal change in ABI or on risk factors for declining ABI in a community-based population. METHODS: To assess risk factors for ABI decline, we studied 5888 participants in the Cardiovascular Health Study cohort (men and women 65 years or older). We measured ABI in 1992-1993 and again in 1998-1999. At baseline, we excluded individuals with an ABI less than 0.9, ABI greater than 1.4, or confirmed symptomatic lower extremity arterial disease (n = 823). The group with ABI decline included 218 participants with decline greater than 0.15 and to 0.9 or less. The comparison group comprised the remaining 2071 participants with follow-up ABI. RESULTS: The percentage of participants with ABI decline was 9.5% over 6 years of follow-up. The mean +/- SD decline was 0.33 +/- 0.12 in cases of ABI decline and 0.02 +/- 0.13 in non-cases. Independent predictors of ABI decline, reported as odds ratios, were age, 1.96 (95% confidence interval [CI], 1.42-2.71) for 75 to 84 years and 3.79 (95% CI, 1.36-10.5) for those older than 85 years compared with those younger than 75 years; current cigarette use, 1.74 (95% CI, 1.02-2.96); hypertension, 1.64 (95% CI, 1.18-2.28); diabetes, 1.77 (95% CI, 1.14-2.76); higher low-density lipoprotein cholesterol level, 1.60 (95% CI, 1.03-2.51), and lipid-lowering drug use 1.74 (95% CI, 1.05-2.89). CONCLUSION: Worsening lower extremity arterial disease, assessed as ABI decline, occurred in 9.5% of this elderly cohort over 6 years and was associated with modifiable vascular disease risk factors.
BACKGROUND: An ankle-brachial index (ABI) of less than 0.9 is a noninvasive measure of lower extremity arterial disease and a predictor of cardiovascular events. Little information is available on longitudinal change in ABI or on risk factors for declining ABI in a community-based population. METHODS: To assess risk factors for ABI decline, we studied 5888 participants in the Cardiovascular Health Study cohort (men and women 65 years or older). We measured ABI in 1992-1993 and again in 1998-1999. At baseline, we excluded individuals with an ABI less than 0.9, ABI greater than 1.4, or confirmed symptomatic lower extremity arterial disease (n = 823). The group with ABI decline included 218 participants with decline greater than 0.15 and to 0.9 or less. The comparison group comprised the remaining 2071 participants with follow-up ABI. RESULTS: The percentage of participants with ABI decline was 9.5% over 6 years of follow-up. The mean +/- SD decline was 0.33 +/- 0.12 in cases of ABI decline and 0.02 +/- 0.13 in non-cases. Independent predictors of ABI decline, reported as odds ratios, were age, 1.96 (95% confidence interval [CI], 1.42-2.71) for 75 to 84 years and 3.79 (95% CI, 1.36-10.5) for those older than 85 years compared with those younger than 75 years; current cigarette use, 1.74 (95% CI, 1.02-2.96); hypertension, 1.64 (95% CI, 1.18-2.28); diabetes, 1.77 (95% CI, 1.14-2.76); higher low-density lipoprotein cholesterol level, 1.60 (95% CI, 1.03-2.51), and lipid-lowering drug use 1.74 (95% CI, 1.05-2.89). CONCLUSION: Worsening lower extremity arterial disease, assessed as ABI decline, occurred in 9.5% of this elderly cohort over 6 years and was associated with modifiable vascular disease risk factors.
Authors: Robin Haring; Thomas G Travison; Shalender Bhasin; Ramachandran S Vasan; Henri Wallaschofski; Maithili N Davda; Andrea Coviello; Joanne M Murabito Journal: J Clin Endocrinol Metab Date: 2011-09-21 Impact factor: 5.958
Authors: Kathryn A Britton; Kenneth J Mukamal; Joachim H Ix; David S Siscovick; Anne B Newman; Ian H de Boer; Evan L Thacker; Mary L Biggs; J Michael Gaziano; Luc Djoussé Journal: Vasc Med Date: 2012-03-08 Impact factor: 3.239
Authors: Parveen K Garg; Mary L Biggs; Mercedes Carnethon; Joachim H Ix; Michael H Criqui; Kathryn A Britton; Luc Djoussé; Kim Sutton-Tyrrell; Anne B Newman; Mary Cushman; Kenneth J Mukamal Journal: Hypertension Date: 2013-11-04 Impact factor: 10.190
Authors: Tiffany M Powell; Robert J Glynn; Julie E Buring; Mark A Creager; Paul M Ridker; Aruna D Pradhan Journal: Vasc Med Date: 2011-07-05 Impact factor: 3.239
Authors: Himabindu Vidula; Kiang Liu; Michael H Criqui; Moyses Szklo; Matthew Allison; Christopher Sibley; Pamela Ouyang; Russell P Tracy; Cheeling Chan; Mary M McDermott Journal: Atherosclerosis Date: 2015-09-03 Impact factor: 5.162
Authors: F Gerry R Fowkes; Victor Aboyans; Freya J I Fowkes; Mary M McDermott; Uchechukwu K A Sampson; Michael H Criqui Journal: Nat Rev Cardiol Date: 2016-11-17 Impact factor: 32.419
Authors: Michel M Joosten; Jennifer K Pai; Monica L Bertoia; Eric B Rimm; Donna Spiegelman; Murray A Mittleman; Kenneth J Mukamal Journal: JAMA Date: 2012-10-24 Impact factor: 56.272