Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle–Brachial Index: U.S. Preventive Services Task Force Recommendation Statement

Introduction: Peripheral artery disease (PAD) is associated with decreased physical function and increased mortality in the general population. PAD is common in women with and at risk for HIV infection, but its association with functional decline is unclear. We examined the contribution of PAD to gait speed in the Women’s Interagency HIV Study, controlling for traditional cardiovascular risk factors and HIV-related factors. Methods: 1,839 participants (72% HIV+) with measured ankle-brachial index (ABI) and 4-meter gait speed were included in analysis. ABI scores were categorized as: <0.7, moderate-severe PAD; 0.7-<0.9, mild PAD; 0.9-<1.0, borderline PAD; 1.0-<1.1, low-normal; 1.1-1.4, normal. Longitudinal regression models with repeated measures were used to examine the association of PAD category with log-transformed gait speed after controlling for demographic, behavioral, and cardiovascular disease risk factors, and HIV and HCV status. Coefficients represented percentage differences. Results: Median age was 50 years, >70% were Black. Figure 1 shows median gait speed by PAD group. In univariate analysis, compared to normal ABI, each category of PAD severity was associated with slower gait speed: 6% slower for low-normal (95% confidence interval [CI]:4%, 9%), 10% for borderline (95% CI:6%, 13%), 14% for mild (95% CI:9%, 18%), and 16% for moderate-severe (95% CI:5%, 25%). In multivariate analysis, PAD severity remained associated with 6% (95% CI:4%, 9%), 10% (95%CI:7%, 14%), 12% (95%CI:8%, 17%), and 11% (95%CI: -1%, 22%) slower gait speed, respectively. HIV/HCV coinfection reduced gait speed by 9% (95%CI:4%, 14%). Among HIV+ women, neither CD4 count nor HIV viral load was associated with gait speed. Conclusions: In middle-aged women with and at risk for HIV, greater PAD severity is associated with progressively slower gait speed. ABI measurement may be a simple and clinically useful tool for early assessment of functional declines.

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Peripheral artery disease assessed by ankle-brachial index in patients with established cardiovascular disease or at least one risk factor for atherothrombosis - CAREFUL Study: A national, multi-center, cross-sectional observational study

BMC Cardiovascular Disorders ◽

10.1186/1471-2261-11-4 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 23

Author(s):

Ahmet K Bozkurt ◽

Ilker Tasci ◽

Omur Tabak ◽

Mehmet Gumus ◽

Yesim Kaplan

Keyword(s):

Cardiovascular Disease ◽

Risk Factor ◽

Observational Study ◽

Peripheral Artery Disease ◽

Ankle Brachial Index ◽

Careful Study ◽

Peripheral Artery ◽

Cross Sectional ◽

Artery Disease

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Anxiety a possible peripheral artery disease risk factor among older Africans: The EPIDEMCA study.

10.21203/rs.2.14144/v1 ◽

2019 ◽

Author(s):

ILEANA DESORMAIS ◽

Philippe Lacroix ◽

Maelenn Guerchet ◽

Bébène Ndamba-Bandzouzi ◽

Pascal Mbelesso ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Disease Risk ◽

Demographic Data ◽

Ankle Brachial Index ◽

Psychosocial Factor ◽

Biological Data ◽

Confounding Factors ◽

Peripheral Artery ◽

Cross Sectional ◽

Artery Disease

Abstract Objective During the past ten years considerable progress has been made in research on cardiac effects of anxiety. On the other hand, epidemiological research on the implication of this psychosocial factor in the development of peripheral artery disease (PAD) is lacking. The present study sought to examine the association of anxiety and PAD in elderly individuals in two sub-Saharan countries in Africa.Methods This cross-sectional study, was performed in urban and rural population in Central Africa: Republic of Congo and Central African Republic. All individuals ≥65 years living in these areas were invited to participate. Socio-demographic data, medical history, medication, clinical and biological data were collected. Anxiety symptoms were assessed with the Geriatric Mental State version B3. Peripheral artery disease was defined as ankle brachial index (ABI) ≤0.90.Results A total of 1662 subjects composed our study population (age 72.9±6.5 years, 59.3% females). Overall, the prevalence of anxiety was 7.2%, significantly higher in women (9.2% vs. 4.3% in men, p<0.001 ). Independently of all confounding factors, anxiety was strongly associated with PAD in both countries (OR: 2.56, 99%CI: .52-4.20) and more frequently associated with PAD in women than in men (OR: 3.37, 95%CI: 1.22-4.10 vs. OR: 2.34, 95%CI: 1.13-5.06).Conclusion Our study underlines the high prevalence of anxiety in African general population in the elderly, as well as a significant association with the peripheral artery disease, independently of all possible confounding factors. The higher rates of anxiety in women and stronger association with PAD as compared to men might explain the higher rates of PAD in African women.

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