Abstract 132: Risk Factors for Lower-Extremity Claudication in South Asians
South Asians have a higher incidence of CAD and diabetes than people of Western descent. Despite this, the rates of peripheral arterial disease (PAD) have been reported to be lower and the risk factors have not been well characterized. To better understand the determinants of PAD in this population we examined participants in the Pakistan Risk of Myocardial Infarction Study (PROMIS), a multi-center case control study of myocardial infarction in Pakistan, for clinical evidence of claudication. 724 (4.8%) of the 15,570 individuals enrolled in PROMIS had symptoms consistent with claudication. These subjects had an average (SD) age of 56 (9.7) years and 536 (74%) were male. Multivariate logistic regression identified the following independent risk factors: age (OR 1.03, 95%, CI 1.02-1.04), female gender (OR 1.7, 95% CI 1.2 - 2.2), ethnicity (OR 1.4 - 4.6 with Punjab as reference), MI (OR 2.2, 95% CI 1.8 - 2.8), prior stroke (OR 2.6, 95% CI 0.9 - 6.2), diabetes (OR 1.3, 95% CI 1.0 - 1.7), family history of hypertension (OR 1.3, 95% CI 1.0 - 1.7), consumption of fried foods (OR 1.8, 95% CI 1.3 - 2.3), sedentary occupation (OR 1.6, 95% CI 1.3 - 2.0), overall sedentary lifestyle (OR 2.5, 1.9 -3.4), being married (OR 1.6, 95% CI 1.0 - 2.8), having a consanguineous spouse (OR 1.3, 95% CI 1.0 - 1.6), minimal formal education (OR 1.9, 95% CI 1.5 - 2.3), and low income (OR 1.2, CI 1.0 - 1.7). The use of ghee (clarified butter) as compared to oil or lard for cooking was protective (OR 0.6, 95% CI 0.5 - 0.8). Although smoking (OR 1.4, 95% CI 1.2 - 1.6) and hypertension (OR 1.3, 95% CI 1.1 - 1.6) were significant risk factors when controlling for age, gender, and ethnicity, they were not independently associated with claudication after adjusting for the other above risk factors (p=0.29 and p=0.28, respectively). These findings suggest that although there is a difference in the prevalence of PAD between South Asian and Western populations, the populations share many of the same risk factors. The association of claudication with spousal consanguinity, as well as female gender and ethnicity, suggest a significant genetic influence that may differ from Western populations and merits further investigation.
Author Disclosures: S.M. Damrauer: None. W. Zhao: None. R.M. Fairman: None. D.J. Rader: None. D. Saleheen: None.
- © 2014 by American Heart Association, Inc.