© 1996 American Heart Association, Inc.
Articles |
Peripheral Artery Disease and Cardiovascular Risk Factors in the Elderly
The Honolulu Heart Program
the Divisions of Clinical Epidemiology and Geriatric Medicine (J.D.C., K.M., B.L.R., H.P.), Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa; the Honolulu Heart Program (J.D.C., K.M., B.L.R., R.C., H.P., K.Y.), Kuakini Medical Center, Honolulu, Hawaii; the Division of Epidemiology and Clinical Applications (C.M.B., D.S.), the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md; and the Division of Biostatistics (R.D.A.), University of Virginia School of Medicine, Charlottesville.
Correspondence to J. David Curb, MD, Divisions of Geriatric Medicine and Clinical Epidemiology, University of Hawaii School of Medicine, 347 N Kuakini St, Honolulu, HI 96817. curb@hhs.cba.hawaii.edu.
Peripheral vascular disease as measured by the ankle/brachial blood pressure index (ABI) is associated with increased risk of mortality and morbidity. Few sources of data on the relationship of risk factors to ABI are available for the elderly, especially those >80 years of age, and minority populations. ABI measurements from the Honolulu Heart Program's fourth reexamination of 3450 ambulatory, elderly Japanese American men indicate that the prevalence of an abnormal ABI, defined as a ratio of <0.9, was 13.6%, increasing from 8.0% in those 71 to 74 years of age to 27.4% in those 85 to 93 years. Associations that were U or J shaped were present for a number of risk factors (higher rates of abnormality [ABI<0.9] in those in the lowest and highest risk factor quintiles) in a cross-sectional analysis. Risk factors measured at baseline were also predictive of an abnormal ABI 25 years later, even after adjustment for multiple risk factors. The odds ratio (OR) for an ABI<0.9 at the 80th percentile of cholesterol compared with that at the 20th percentile was 1.4; the OR for 1-hour postload glucose was 1.3, and for alcohol intake 1.2. The OR associated with hypertension was 1.8 and that for smoking, 2.9 (P<.05 for all ORs). These findings are consistent with ABI being a marker for generalized atherosclerotic disease in old and very old Japanese American men.
Key Words: elderly • peripheral artery disease • risk factor
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