The Relationship Between Serum Bilirubin Levels and Peripheral Arterial Disease and Gender Difference in Patients With Hypertension: BEST Study

We evaluated the relationship between serum bilirubin levels and ankle-brachial index (ABI) to determine whether gender affected the relationship between bilirubin levels and peripheral arterial disease (PAD) in patients with hypertension. A total of 543 patients were included in our studies (78 patients with PAD and 465 without PAD). Peripheral arterial disease was defined as ABI <0.90 for either and/or both sides. Serum bilirubin levels were measured with a vanadate oxidation method by using fasting venous blood samples. Serum total bilirubin (TBiL) and direct bilirubin (DBiL) levels were higher in males compared with females (both P < .05). Total bilirubin and DBiL were significantly lower in the PAD group. After adjustment for cardiovascular risk factors, PAD was independently negatively related to TBiL and DBiL, with odds ratios (OR) 0.914 (95% confidence interval [CI]: 0.845-0.990) and 0.748 (95% CI: 0.572-0.977). In addition, there was a relationship between PAD and bilirubin levels (TBiL—OR = 0.884, 95% CI: 0.792-0.985; DBiL—OR = 0.621; 95% CI: 0.424-0.909) only in males but not in females. Future studies should further evaluate whether interventions that increase serum bilirubin levels will have a particular role in PAD prevention in males.

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Serum Total Bilirubin Level and Prevalent Lower-Extremity Peripheral Arterial Disease

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvbaha.107.153262 ◽

2008 ◽

Vol 28 (1) ◽

pp. 166-172 ◽

Cited By ~ 131

Author(s):

Todd S. Perlstein ◽

Reena L. Pande ◽

Joshua A. Beckman ◽

Mark A. Creager

Keyword(s):

Peripheral Arterial Disease ◽

Lower Extremity ◽

Bilirubin Level ◽

Total Bilirubin ◽

Total Bilirubin Level ◽

Arterial Disease ◽

Serum Total Bilirubin ◽

Peripheral Arterial

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The arteriomobil project for peripheral arterial disease

VASA ◽

10.1024/0301-1526.37.4.345 ◽

2008 ◽

Vol 37 (4) ◽

pp. 345-352 ◽

Cited By ~ 5

Author(s):

Pfeiffer ◽

Bock ◽

Hohenberger ◽

Kröger

Keyword(s):

Peripheral Arterial Disease ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Computer Assisted ◽

German Population ◽

Co Morbidity ◽

History Of ◽

And Gender ◽

Peripheral Arterial ◽

Self Help Groups

Background: Peripheral Arterial Disease in Germany is underestimated with regard to incidence and the consequences. In 1997 the Federal Association of the Peripheral Arterial Disease Self Help Groups started the Arteriomobil Project to increase the awareness for venous and arterial diseases in the general population. We report peripheral arterial disease (PAD) prevalence rates and discuss the unique concept of this project. Patients and methods: The Arteriomobil is a mobile home modified to a simple investigation room with an examination couch, a Doppler equipment and a computer for data acquisition. From April 1997 to April 2007, a total of 14.785 volunteers aged 18 to 102 years (mean age ± SD: 64 ± 11 years, 63% females) were investigated. Patients were recruited as a result of their active visit to the Arteriomobil and their active participation in the investigation. In all participants the medical history was documented according to a standardized computer-assisted interview and a standardized Ankle Brachial Index (ABI) determined. Results: PAD prevalence in females (ABI < 0.9) increased from 2% in the 5th decade of life to 33% in 10th decade and in males from 4.8% to 41% accordingly. Age- and gender-adjusted odds ratios for PAD were highest in smoker: Odds ratio 2.85 (95% Confidence interval 2.5–3.2) and Diabetes mellitus 1.91 (95%CI 1.7–2.2). Hypertension and hypercholesterolemia had a lower impact. Family history of known PAD, CHD or CVD had no impact. Although 49.5% of all participants complained of "leg disorders during exercise" intermittent claudication turned out to be the most discriminating symptom for PAD 5.87 (95%IC 5.18–6.66). Previous myocardial infarction (MI) was the most frequently reported vascular co-morbidity in those with PAD (OR 2.23, 95%IC 1.9–2.7) followed by stroke (2.12, 1.7–2.7), angina pectoris (1.50, 1.3–1.8) and paresis (2.01, 1.6–2.6). The incidence of anti-platelet treatment was significantly higher in participants with coronary heart disease than in those with PAD or cerebrovascular disease. Conclusions: The Arteriomobil Project is the largest database regarding the prevalence of PAD in the German population. and the data underlines the high prevalence of PAD in Germany.

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Short stature in men is associated with subclinical peripheral arterial disease

VASA ◽

10.1024/0301-1526/a000566 ◽

2016 ◽

Vol 45 (6) ◽

pp. 486-490

Author(s):

Arto Heikkilä ◽

Maarit Venermo ◽

Hannu Kautiainen ◽

Pertti Aarnio ◽

Päivi Korhonen

Keyword(s):

Cardiovascular Risk ◽

Peripheral Arterial Disease ◽

Short Stature ◽

Smoking Status ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Inverse Association ◽

Cross Sectional ◽

Peripheral Arterial ◽

The Relationship

Abstract. Background: Peripheral arterial disease (PAD) affects approximately 202 million individuals around the world and is associated with a high risk of myocardial infarction, stroke and death. Although there is a clear inverse association between adult height and the risk of cardiovascular disease, little is known about the relationship between height and PAD. The aim of our study was to assess the relationship between subclinical PAD and height. Patients and methods: In a cross-sectional cardiovascular risk factor study in southwestern Finland, ankle brachial index (ABI) and other risk factors were measured from a total of 972 cardiovascular risk subjects derived from the general population. None of them had previously diagnosed diabetes, cardiovascular or renal disease or intermittent claudication. Subjects with an ABI ≤ 0.90 were categorized as having subclinical PAD. Results: The average age of the study subjects was 58.1 ± 6.7 years for men and 58.8 ± 6.9 years for women. The prevalence of subclinical PAD was 5 % (95 % CI 3 % − 7 %) (23/455) among men and 5 % (95 % CI 3 %−7 %) (26/517) among women. The mean ABI among men and women was 1.09 ± 0.12 and 1.08 ± 0.12, respectively. In men, there was an inverse association between height and the prevalence of subclinical PAD (p < 0.001) along with a positive association between height and ABI values (p < 0.001). In a multivariate model, height, age and current smoking status remained independent factors that were associated with subclinical PAD in men, whereas in women, only pulse pressure was associated with subclinical PAD. Conclusions: Short stature in men is associated with subclinical PAD and lower ABI values.

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U-shaped association between serum bilirubin levels and peripheral arterial disease in Chinese males with hypertension

10.21203/rs.3.rs-40589/v2 ◽

2020 ◽

Author(s):

Yumeng Shi ◽

Lihua Hu ◽

Minghui Li ◽

Xiao Huang ◽

Congcong Ding ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Inflection Point ◽

Total Bilirubin ◽

Arterial Disease ◽

Cross Sectional Study ◽

Serum Total Bilirubin ◽

Cross Sectional ◽

Artery Disease ◽

Peripheral Arterial ◽

The Right

Abstract Background: Previous studies have indicated that serum total bilirubin might play an important role in peripheral artery disease (PAD). However, the effects of different levels of serum total bilirubin (TBiL) on PAD development remain uncertain, and there are limited data in male participants. We aimed to examine the prevalence of PAD and TBiL among Chinese male adults with hypertension.Methods: A total of 5129 hypertensive male subjects aged 27-93 years were included in the current study. The outcome was peripheral arterial disease (PAD), defined as present when the ABI of either side was ≤ 0.90.Results: Of 5129 hypertensive male participants, 194 (3.78%) had PAD, and the mean serum total bilirubin was 15.67 (7.76) μmol/L. Compared to participants in Q2-Q3 of LgTBiL, there was a significantly increased prevalence of PAD for participants in both Q1 (OR, 1.49; 95% CI: 1.04-2.14) and Q4 (OR, 1.70; 95% CI: 1.16-2.48). After adjusting for potential confounders, a nonlinear U-shaped relationship was detected between TBiL and the prevalence of PAD, and the inflection point was calculated to be 1.08 (LgTBiL = 1.08, TBiL = 12.02 μmol/L). The ORs (95% CIs) were 0.11 (0.02, 0.83) on the left side of the inflection point and 5.26 (1.59, 17.38) on the right side of the inflection point. Similar results were found in various subgroups.Conclusions: This cross-sectional study showed that there was a U-shaped curve for the prevalence of PAD with TBiL concentration in Chinese males with hypertension, with a turning point at 12.02 μmol/L.

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Association between frailty and peripheral arterial disease

Revista Brasileira de Fisiologia do Exercício ◽

10.33233/rbfe.v19i2.3891 ◽

2020 ◽

Vol 19 (2) ◽

pp. 124

Author(s):

Sérgio Ribeiro Barbosa ◽

Natália Rodrigues Dos Reis ◽

Henrique Novais Mansur

Keyword(s):

Peripheral Arterial Disease ◽

Descriptive Analysis ◽

Ankle Brachial Index ◽

Female Gender ◽

Arterial Disease ◽

Sociodemographic Factors ◽

Genetic Alterations ◽

Index Test ◽

Peripheral Arterial ◽

The Relationship

Background: Frailty has been associated with lifestyle, chronic diseases, and genetic alterations and with high levels of proinflammatory proteins, justifying the relationship proposed by the emerging literature that seeks associations between frailty and cardiovascular diseases. Objective: To investigate clinical and sociodemographic factors associated with frailty, emphasizing the relationship with peripheral arterial disease. Methods: Medical records of 76 patients were analyzed, considering the results of the ankle-brachial index test, fragility, sociodemographic and clinical variables. After the descriptive analysis, differences between groups were tested by chi-square test, student’s t-test and Tukey's post hoc test, when they were appropriated. The value of p < 0.05 for statistically significant differences was considered. Results: The prevalence of frailty in the study sample was 22.3%, and 47.3% for pre-frail. Frailty was associated with female gender, hypertension, dyslipidemia and level of education. Changes in ankle-brachial index test were statistically associated with frailty. Conclusion: The results of this research show the necessary targeted efforts to prevent and treat frailty.Keywords: peripheral arterial disease, cardiovascular disease, chronic disease, fragility.

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U-Shaped Association Between Serum Bilirubin Levels and Peripheral Arterial Disease in Chinese Males with Hypertension

10.21203/rs.3.rs-40589/v1 ◽

2020 ◽

Author(s):

Yumeng Shi ◽

Lihua Hu ◽

Minghui Li ◽

Xiao Huang ◽

Congcong Ding ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Inflection Point ◽

Total Bilirubin ◽

Arterial Disease ◽

Cross Sectional Study ◽

Serum Total Bilirubin ◽

Cross Sectional ◽

Increased Risk ◽

Peripheral Arterial ◽

The Right

Abstract Background: Previous studies indicated that serum total bilirubin might play an important role in peripheral artery disease (PAD). However, the effects of different levels of serum total bilirubin (TBiL) on PAD development remain an uncertainty and had limited data in male participants. We aimed to examine the prevalence of PAD and TBiL among Chinese male adults with hypertension.Methods: A total of 5129 hypertension male subjects aged 27-93 years was included in the current study. The outcome was a peripheral arterial disease (PAD), defined as present when ABI of either sides was ≤ 0.90.Results: Of 5,129 hypertension male participants, 194 (3.78%) had PAD, and the median serum concentrations of TBiL were 14.10 μmol/L (interquartile range 11.00 to18.60 μmol/L). Compared to participants in Q2-Q3 of LgTBiL, there was a significantly increased risk of PAD for participants in both Q1 (OR,1.49; 95%CI: 1.04-2.14) and Q4 (OR,1.70; 95%CI: 1.16-2.48). After adjusting for potential confounders, a nonlinear U-shaped relationship was detected between TBiL and PAD, and calculated the inflection point was 1.08 (LgTBiL = 1.08, TBiL = 12.02 μmol/L). The ORs (95% CIs) were 0.11 (0.02, 0.83) on the left side of an inflection point and 5.26 (1.59, 17.38) on the right side of the inflection point, respectively. Similar results were found in various subgroups.Conclusions: This cross-sectional study had shown that there was a U-shaped curve for the risk of PAD with TBiL concentration in Chinese males with hypertension, with a turning point at 12.02 μmol/L.

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Hallucal thenar index: A new index to detect peripheral arterial disease using laser speckle flowgraphy

Vascular ◽

10.1177/1708538120938935 ◽

2020 ◽

pp. 170853812093893

Author(s):

Kazuhiro Tsunekawa ◽

Fumio Nagai ◽

Tamon Kato ◽

Ikkei Takashimizu ◽

Daisuke Yanagisawa ◽

...

Keyword(s):

Blood Flow ◽

Peripheral Arterial Disease ◽

Operating Characteristic ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Laser Speckle ◽

Laser Speckle Flowgraphy ◽

Skin Perfusion ◽

Peripheral Arterial ◽

Cutaneous Blood

Objectives Laser speckle flowgraphy is a technology using reflected scattered light for visualization of blood distribution, which can be used to measure relative velocity of blood flow easily without contact with the skin within a short time. It was hypothesized that laser speckle flowgraphy may be able to identify foot ischemia. This study was performed to determine whether laser speckle flowgraphy could distinguish between subjects with and without peripheral arterial disease. Materials and methods All subjects were classified based on clinical observations using the Rutherford classification: non-peripheral arterial disease, class 0; peripheral arterial disease group, class 2–5. Rutherford class 6 was one of the exclusion criteria. Laser speckle flowgraphy measured the beat strength of skin perfusion as an indicator of average dynamic cutaneous blood flow change synchronized with the heartbeat. The beat strength of skin perfusion indicates the strength of the heartbeat on the skin, and the heartbeat strength calculator in laser speckle flowgraphy uses the blood flow data to perform a Fourier transform to convert the temporal changes in blood flow to a power spectrum. A total of 33 subjects with peripheral arterial disease and 40 subjects without peripheral arterial disease at a single center were prospectively examined. Laser speckle flowgraphy was used to measure hallucal and thenar cutaneous blood flow, and the measurements were repeated three times. The hallucal and thenar index was defined as the ratio of beat strength of skin perfusion value on hallux/beat strength of skin perfusion value on ipsilateral thenar eminence. The Mann–Whitney U-test was used to compare the median values of hallucal and thenar index and ankle brachial index between the two groups. A receiver operating characteristic curve for hallucal and thenar index of beat strength of skin perfusion was plotted, and a cutoff point was set. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index was explored in all subjects, the hemodialysis group, and the non-hemodialysis (non-hemodialysis) group. Results The median value of the hallucal and thenar index of beat strength of skin perfusion was significantly different between subjects with and without peripheral arterial disease (0.27 vs. 0.87, respectively; P < 0.001). The median value of ankle brachial index was significantly different between subjects with and without peripheral arterial disease (0.8 vs. 1.1, respectively; P < 0.001). Based on the receiver operating characteristic of hallucal and thenar index, the cutoff was 0.4416 and the sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 95%, 91.7%, and 77.6%, respectively. The correlation coefficients of all subjects, the hemodialysis group, and the non-hemodialysis group were 0.486, 0.102, and 0.743, respectively. Conclusions Laser speckle flowgraphy is a noninvasive, rapid, and widely applicable method. Laser speckle flowgraphy using hallucal and thenar index would be helpful to determine the differences between subjects with and without peripheral arterial disease. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index indicated that this index was especially useful in the non-hemodialysis group.

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