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Titolo:
ANKLE-ARM INDEX AS A MARKER OF ATHEROSCLEROSIS IN THE CARDIOVASCULAR HEALTH STUDY
Autore:
NEWMAN AB; SISCOVICK DS; MANOLIO TA; POLAK J; FRIED LP; BORHANI NO; WOLFSON SK;
Indirizzi:
UNIV WASHINGTON,CHS COORDINATING CTR,JD-30,1107 NE 45TH ST,SUITE 530 SEATTLE WA 98105 MED COLL PENN,DEPT MED PITTSBURGH PA 00000 UNIV WASHINGTON,DEPT MED & EPIDEMIOL SEATTLE WA 98195 NHLBI,DIV EPIDEMIOL & CLIN APPLICAT BETHESDA MD 20892 BRIGHAM & WOMENS HOSP,DEPT RADIOL BOSTON MA 02115 JOHNS HOPKINS UNIV,SCH MED,DEPT MED & EPIDEMIOL BALTIMORE MD 21205 UNIV CALIF DAVIS,SCH MED,DEPT MED DAVIS CA 95616 UNIV PITTSBURGH,DEPT SURG PITTSBURGH PA 15260
Titolo Testata:
Circulation
fascicolo: 3, volume: 88, anno: 1993,
pagine: 837 - 845
SICI:
0009-7322(1993)88:3<837:AIAAMO>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERIPHERAL ARTERIAL-DISEASE; ISCHEMIC-HEART-DISEASE; INTERMITTENT CLAUDICATION; VASCULAR-DISEASE; RISK-FACTORS; MYOCARDIAL-INFARCTION; SYSTOLIC HYPERTENSION; PREVALENCE; POPULATION; FRAMINGHAM;
Keywords:
PERIPHERAL VASCULATURE; EPIDEMIOLOGY; AGING; TESTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
A.B. Newman et al., "ANKLE-ARM INDEX AS A MARKER OF ATHEROSCLEROSIS IN THE CARDIOVASCULAR HEALTH STUDY", Circulation, 88(3), 1993, pp. 837-845

Abstract

Background. Peripheral arterial disease measured noninvasively by theankle-arm index (AAI) is common in older adults, largely asymptomatic, and associated with clinically manifest cardiovascular disease (CVD). The criteria for an abnormal AAI have varied in previous studies. Todetermine whether there is an inverse dose-response relation between the AAI and clinical CVD, subclinical disease, and risk factors, we examined the relation of the AAI to cardiovascular risk factors, other noninvasive measures of subclinical atherosclerosis using carotid ultrasound, echocardiography and electrocardiography, and clinical CVD. Methods and Results. The AAI was measured in 5084 participants greater-than-or-equal-to 65 years old at the baseline examination of the Cardiovascular Health Study. All subjects had detailed assessment of prevalent CVD, measures of cardiovascular risk factors, and noninvasive measures of disease. Participants were stratified by baseline clinical CVD status and AAI (<0.8, greater-than-or-equal-to 0.8 to <0.9, greater-than-or-equal-to 0.9 to <1.0, greater-than-or-equal-to 1.0 to <1.5). Analyses tested for a dose-response relation of the AAI with clinical CVD,risk factors, and subclinical disease. The cumulative frequency of a low AAI was 7.4% of participants <0.8, 12.4% <0.9, and 23.6% <1.0. Participants with an AAI <0.8 were more than twice as likely as those within AAI of 1.0 to 1.5 to have a history of myocardial infarction, angina, congestive heart failure, stroke, or transient ischemic attack (all P<.01). In participants free of clinical CVD at baseline, the AAI was inversely related to history of hypertension, history of diabetes, and smoking, as well as systolic blood pressure, serum creatinine, fasting glucose, fasting insulin, measures of pulmonary function, and fibrinogen level (all P<.01). Risk factor associations with the AAI were similar in men and women free of CVD except for serum total and low-density lipoprotein cholesterol, which were inversely associated with AAIlevel only in women. Risk factors associated with an AAI of <1.0 in multivariate analysis included smoking (odds ratio [OR], 2.55), historyof diabetes (OR, 3.84), increasing age (OR, 1.54), and nonwhite race (OR, 2.36). In the 3372 participants free of clinical CVD, other noninvasive measures of subclinical CVD, including carotid stenosis by duplex scanning, segmental wall motion abnormalities by echocardiogram, and major ECG abnormalities were inversely related to the AAI (all P<.01). Conclusions. There was an inverse dose-response relation of the AAIwith CVD risk factors and subclinical and clinical CVD among older adults. The lower the AAI, the greater the increase in CVD risk; however, even those with modest, asymptomatic reductions in the AAI (0.8 to 1.0) appear to be at increased risk of CVD.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 12:22:39