Abstract P306: Proportion of Community-dwelling Older Adults Potentially Benefiting From the Detection of Peripheral Arterial Disease (PAD) With Ankle-Brachial Index: the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Yijing Feng ◽  
Shoshana Ballew ◽  
Corey A Kalbaugh ◽  
Michelle L Meyer ◽  
Hirofumi Tanaka ◽  
...  
2005 ◽  
Vol 180 (2) ◽  
pp. 389-397 ◽  
Author(s):  
Keattiyoat Wattanakit ◽  
Aaron R. Folsom ◽  
Elizabeth Selvin ◽  
Beth D. Weatherley ◽  
James S. Pankow ◽  
...  

2007 ◽  
Vol 18 (2) ◽  
pp. 629-636 ◽  
Author(s):  
Keattiyoat Wattanakit ◽  
Aaron R. Folsom ◽  
Elizabeth Selvin ◽  
Josef Coresh ◽  
Alan T. Hirsch ◽  
...  

2005 ◽  
Vol 10 (3) ◽  
pp. 199-206 ◽  
Author(s):  
Keattiyoat Wattanakit ◽  
Janice E Williams ◽  
Pamela J Schreiner ◽  
Alan T Hirsch ◽  
Aaron R Folsom

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Corey A Kalbaugh ◽  
Anna Kucharska-Newton ◽  
Laura Loehr ◽  
Elizabeth Selvin ◽  
Aaron R Folsom ◽  
...  

Introduction: Lower extremity peripheral arterial disease (PAD) affects between 12% and 20% of Americans over the age of 65. PAD compromises quality of life, contributes a high burden of disability and its related health care costs exceed $4 billion/year, yet this preventable CVD outcome remains understudied. Aims: Assess the incidence of hospitalized PAD, and of the most severe form of PAD, critical limb ischemia (CLI), in middle-aged men and women, and evaluate their risk factors in a bi-ethnic, population-based cohort. We hypothesized that incidence of hospitalized PAD and CLI are higher in African Americans, and that modifiable atherosclerosis risk factors in middle age predict these sequelae of PAD. Methods: We analyzed data from 13,865 participants from the Atherosclerosis Risk in Communities Study aged 45–64 without PAD at baseline (1987–89). Incident PAD and CLI events were identified using ICD-9 codes from active surveillance of all hospitalizations among cohort participants from 1987 through 2008. All estimates are incidence rates per 10,000 person-years; nominal statistical significance was achieved for all baseline characteristic comparisons reported. Results: There were 707 incident hospitalized PAD during a median of 18 years of follow-up (249,570 person-years). The overall age-adjusted incidence of PAD and limb-threatening CLI were 26.0 and 9.6 per 10,000 person-years, respectively. Incidence of hospitalized PAD was higher in African Americans than whites (34.7 vs. 23.2) and in men compared to women (32.4 vs. 26.7). Baseline characteristics associated with age-adjusted incident PAD (per 10,000 person-years) compared to their referent groups were diabetes (91.2 vs. 19.0), history of smoking (33.6 vs. 16.2), hypertension (42.6 vs. 18.6), coronary heart disease (81.4 vs. 24.1), and obesity (41.5 vs. 20.2). Incidence of CLI also was higher among African Americans (21.0 vs. 5.9) and in men (10.5 vs. 8.9 per 10,000 person-years). Baseline characteristics associated with incident CLI were similar to those for PAD. Conclusions: The absolute risk of hospitalized lower extremity PAD in this community-based cohort is of a magnitude similar to that of heart failure and of stroke. As modifiable factors are strongly predictive of the long-term risk of hospitalized PAD and CLI, particularly among African Americans, our results highlight the need for effective risk factor prevention and control.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Rachel P Ogilvie ◽  
Pamela L Lutsey ◽  
Gerardo Heiss ◽  
Aaron R Folsom ◽  
Lyn M Steffen

Background: Peripheral arterial disease (PAD) is a costly source of morbidity and mortality among older persons in the United States. Dietary intake plays a role in the development of atherosclerotic cardiovascular disease; however, few studies have examined the relation of food intake or diet patterns with PAD. Objectives: We examined the relationship between habitual dietary intake at midlife and incident PAD over approximately 20 years of follow-up. Methods: Among 14,082 participants enrolled in the Atherosclerosis Risk in Communities (ARIC) study initially free of PAD, dietary intake was assessed at baseline in 1987-1989 using a Harvard food frequency questionnaire. Food groups were created and principal components analysis was used to develop “healthy” and “Western” dietary patterns; both were categorized into quintiles or quartiles. Incident PAD was defined by an ankle-brachial index (ABI) measure of < 0.90 at either of two subsequent exams (1993-1995, 1996-1998), or a hospital discharge diagnosis of PAD, leg amputation, or leg revascularization procedures through 2012. Cox proportional hazards models adjusted for relevant confounders assessed the relations of each food group or diet pattern with incident PAD. Results: During a mean follow up of 19.9 years, 1569 participants developed incident PAD. A total of 64.7% of cases had their incident event defined via ICD-9 codes, while 35.3% had incident PAD defined by ABI. In models adjusted for demographics, behaviors, and food groups, the hazard ratios for incident PAD increased across quintiles of meat consumption (Q2 vs. Q1 1.38 [95% CI 1.16, 1.64], Q3 vs. Q1 1.40 [1.18, 1.67], Q4 vs. Q1 1.47 [1.23, 1.77], Q5 vs. Q1 1.66 [1.36, 2.03], p for trend <0.001). Compared to those who drank no alcohol, those who had 1-6 drinks per week had a lower risk of incident PAD (HR=0.78 [95% CI 0.68, 0.89]). For coffee, there was a modest inverse association with incident PAD (Q5 vs. Q1 0.84 [0.75, 1.00], p for trend = 0.014). There was no association between other food groups or patterns and incident PAD. Conclusions: In this prospective population-based cohort study, greater meat consumption was associated with higher risk of incident PAD, while both moderate alcohol consumption and coffee consumption were associated with lower risk of incident PAD. Whether these associations are causal remains to be seen.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jingkai Wei ◽  
Priya Palta ◽  
Aozhou Wu ◽  
Michelle Meyer ◽  
A. Richey Sharret ◽  
...  

Background: Vascular aging is associated with cognitive decline. Aortic stiffness is a hallmark of vascular aging. We tested the hypothesis that greater aortic stiffness is associated with a faster rate of cognitive decline over 5 years among older adults. Methods: A prospective cohort study at the 5th (2011-2013) and 6th (2016-2017) examinations of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) was conducted to quantify the association between baseline aortic stiffness and cognitive decline over 5 years. A total of 4639 participants (mean age: 75 years, 41% men, 22% Black) with baseline measures of aortic stiffness and cognitive function were included in the analysis. Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV) using the Omron VP-1000 Plus device and analyzed continuously per 1 standard deviation meter/second (3.20 m/s). Elevated aortic stiffness was defined as the upper 25th percentile of cfPWV (13.39 m/s). Cognitive function was based on ten neuropsychological tests across multiple domains of cognition, including memory, executive function/processing speed, and language. A global cognitive performance factor score was estimated based on all cognitive tests at both visits. Multivariable linear regression was used to examine the associations of each standard deviation (SD) increment in cfPWV and elevated cfPWV with annual cognitive decline over 5 years. Interactions with baseline cognitive status were assessed. To account for attrition (35% over 5 years), multiple imputation by chained equations was used to impute missing global cognitive performance factor scores at visit 6. Results: Each 1 SD increase in cfPWV was associated with 0.008 SD (Beta (β)=-0.008, 95% confidence interval (CI): -0.010, -0.003) annual rate of decline in cognitive function after adjustment for age, sex, education, race-center and ApoE4. With additional adjustment for ever smoking, total weekly physical activity time, mean arterial pressure, diabetes, and body mass index, each SD higher cfPWV was associated with 0.005 SD (β=-0.005, 95% CI: -0.010, -0.001) annual rate of decline in cognitive function. Elevated cfPWV was associated with 0.015 SD (β=-0.015, 95% CI: -0.024, -0.005) annual decline in cognitive function, and with 0.010 SD (β=-0.010, 95% CI: -0.020, 0.0001) annual decline after additional adjustment. Conclusion: Higher aortic stiffness is associated with the rate of decline in global cognitive function among community-dwelling older adults. The hemodynamic sequelae of aortic stiffening may contribute to cognitive decline among older adults.


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