Associations of lower-limb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: The Atherosclerosis Risk in Communities (ARIC) study

Stone, Keeron J ORCID: 0000-0001-6572-7874, Fryer, Simon M ORCID: 0000-0003-0376-0104, Faulkner, James, Meyer, Michelle L., Heffernan, Kevin, Kucharska-Newton, Anna, Zieff, Gabriel H, Paterson, Craig ORCID: 0000-0003-3125-9712, Matsushita, Kunihiro, Hughes, Timothy, Tanaka, Hirofumi and Stoner, Lee (2022) Associations of lower-limb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: The Atherosclerosis Risk in Communities (ARIC) study. Atherosclerosis, 340. pp. 53-60. doi:10.1016/j.atherosclerosis.2021.10.014

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BACKGROUND & AIMS Atherosclerosis and arteriosclerosis contribute to vascular aging and cardiovascular disease (CVD) risk. Both processes can be assessed simply in the lower-limbs and reflect systemic pathology. However, only atherosclerosis is routinely assessed, typically via ankle-brachial index (ABI). Arteriosclerosis can be assessed using femoral-ankle pulse wave velocity (faPWV), but no studies have identified whether ABI and faPWV similarly associate with overt CVD and risk factors, nor whether faPWV confers additional information. The aims of this study were to, (i) Compare associations of ABI and faPWV with traditional CVD risk factors, including age, sex, systolic blood pressure (SBP), high-density lipoprotein (HDL), total cholesterol (TC), smoking, and diabetes; and, ii) Determine the independent and additive associations of ABI and faPWV with a composite measure of prevalent CVD. METHODS We evaluated ABI and faPWV in 4,330 older-aged (75.3±5.0 years) adults using an oscillometric screening device. Associations between ABI and faPWV with CVD risk factors and CVD were determined using mixed-model linear- and logistic-regression. RESULTS ABI and faPWV were associated with age, HDL, and smoking. ABI was associated with sex, TC, diabetes. faPWV was associated with SBP. Both ABI and faPWV were inversely associated with CVD. Low ABI (≤0.9 vs. >0.9) and low faPWV (≤9.94 vs. >9.94) increased the odds of CVD by 2.41-fold (95% CI:1.85,3.17) and 1.46-fold (95% CI:1.23,1.74), respectively. The inverse association between faPWV and CVD was independent of ABI and CVD risk factors. CONCLUSION ABI and faPWV, measures of lower-limb atherosclerosis and arteriosclerosis, are independently associated with CVD risk factors and prevalent CVD. Assessment of faPWV may confer additional risk information beyond ABI.

Item Type: Article
Article Type: Article
Uncontrolled Keywords: Ankle-brachial index; Femoral-ankle pulse wave velocity; Cardiovascular risk factors; Arterial stiffness; Peripheral artery disease; Coronary heart disease; Heart failure; Stroke
Subjects: R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.C68 Coronary heart disease
Divisions: Schools and Research Institutes > School of Education and Science
Research Priority Areas: Health, Life Sciences, Sport and Wellbeing
Depositing User: Rhiannon Goodland
Date Deposited: 02 Nov 2021 13:58
Last Modified: 31 Aug 2023 09:07

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