Abstract 14788: Modifiable Risk Factor Burden and the Prevalence of Peripheral Artery Disease in Different Vascular Territories
Background: The precise relationship between risk factor burden and prevalence of peripheral vascular disease in different arterial territories (peripheral artery disease [PAD], carotid artery stenosis [CAS], and abdominal aortic aneurysm [AAA]) is unclear.
Methods: We investigated the association of modifiable risk factors (hypertension, hypercholesterolemia, smoking, diabetes, and sedentary lifestyle) with any and type-specific peripheral vascular disease among 3.3 million United States adults, aged 40-99, who underwent screening bilateral ankle brachial indices, carotid duplex ultrasound and abdominal aortic ultrasound in the Life Line Screening program between 2004-2008. Multivariate logistic regression analysis was used to estimate odds of disease in different risk factor categories.
Results: Among 3,319,993 participants, prevalence of any peripheral vascular disease was 7.51% (95% confidence interval [CI] 7.50-7.53). PAD was present in 3.56% (3.54 - 3.58), CAS in 3.94% (3.92 - 3.96), and AAA in 0.88% (0.86 - 0.89). The multivariate adjusted prevalence for any peripheral vascular disease with the presence of 0, 1, 2, 3, 4, and 5 modifiable risk factors was 2.76, 4.63, 7.12, 10.73, 16.00, and 22.08 (P<0.0001 for trend); 1.18, 2.09, 3.28, 5.14, 8.32, and 12.43 (P<0.0001 for trend) for PAD; 1.41, 2.36, 3.72, 5.73, 8.48, and 11.58 (P<0.0001 for trend) for CAS; and 0.31, 0.54, 0.85, 1.28, 1.82, and 2.39 (P<0.0001 for trend) for AAA, respectively. These associations were similar for men and women. For every additional modifiable risk factor that was present, the multivariate adjusted odds of vascular disease increased significantly (any peripheral vascular disease (odds ratio [OR] 1.58, 95% CI 1.58-1.59); PAD (OR 1.62, 95% CI 1.62-1.63); CAS (OR 1.57, 95% CI 1.56-1.57); and AAA (OR 1.51, 95% CI 1.50-1.53).
Conclusion: This very large contemporary database demonstrates that risk factor burden is associated with an increased prevalence of peripheral vascular disease, and there is a graded association between the number of risk factors present and the prevalence of PAD, CAS, and AAA.
- © 2012 by American Heart Association, Inc.