Abstract 13135: Demographics, Clinical Risk Factors and Peripheral Vascular Disease Among 3.6 Million Adults
Background: Peripheral vascular disease (PVD) is associated with significant morbidity and mortality. The precise relationship between age, sex, race, clinical cardiovascular risk factors and prevalence of disease in different vascular territories is uncertain.
Methods: A prospective database of more than 3.5 million U.S. adults from 2003-2008 who completed a medical and lifestyle questionnaire and were evaluated by carotid and abdominal ultrasound imaging for the presence of internal carotid artery >50% stenosis (CAS) and abdominal aortic aneurysm >3cm (AAA), respectively, as well as ankle brachial indices <0.9 for the detection of peripheral artery disease (PAD). Risk factors associated with PVD were identified using multivariate logistic regression analysis.
Results: Among 3.6 million adults, any PVD was found in 274,891 (7.4%) adults (carotid-3.8%, AAA-0.9%, and PAD-3.6%). The prevalence of any PVD increased with increasing age (<40 - 1.6%, 41-60 - 3.1%, 61-80 - 9%, >80 - 21.1%, P<0.0001). Women were less likely to have PVD than men (6.9% vs 8.4%, P<0.0001). Race was significantly associated with any PVD (White-7.4%, Black-8.6%, Hispanic-4.4%, Asian-4.3%, Native American-12.0%, other-7.4%, P<0.0001). Subjects with PVD were more likely obese, smokers, and have a history of diabetes, hypertension, and hypercholesterolemia (P<0.0001 for all). Multivariate analysis identified age as the strongest predictor of any PVD (OR for every decile 1.91, 95% CI: 1.90-1.92) followed by smoking (OR 2.09, 95% CI 2.07-2.11) and hypertension (OR 1.52, 95% CI 1.50-1.53). Age and smoking were the strongest risk factors for each vascular phenotype, yet, the strength of other risk factors differed according to vascular phenotype (hypertension was the strongest risk factor for carotid; male sex for AAA; and diabetes for PAD).
Conclusion: This very large contemporary database shows that PVD is common and associated with traditional cardiovascular risk factors; however, risk factors differed across the spectrum of PVD. This has significant implications for risk factor reduction strategies, as well as for selection of appropriate populations for widespread screening for occult PVD.
- © 2011 by American Heart Association, Inc.