TY - JOUR
T1 - Ethnic differences in ankle brachial index are present in middle-aged individuals without peripheral arterial disease
AU - Singh, Siddharth
AU - Bailey, Kent R.
AU - Kullo, Iftikhar J.
N1 - Funding Information:
This work was supported in part by NIH grant HL-75794 . The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.
PY - 2013/1/20
Y1 - 2013/1/20
N2 - Introduction: To better understand the basis for previously reported ethnic differences in ankle brachial index (ABI), we investigated whether these differences were present in individuals without known peripheral arterial disease (PAD). Methods: We used data from National Health and Nutrition Examination surveys (NHANES 1999-2004) to determine whether ethnic differences were present in respondents without PAD (1 ≤ ABI ≤ 1.3). We assessed whether ethnicity was an independent predictor of ABI and ankle systolic blood pressure (SBP) in linear regression models that adjusted for conventional and novel cardiovascular risk factors. To minimize effects of atherosclerosis on ABI, we studied adults aged ≤ 60 years, and also repeated our analyses in a subset aged ≤ 50 years that did not have risk factors for PAD. Results: 3348 participants aged ≤ 60 years were included in the study. Mean ABI was 1.11 in non-Hispanic Blacks (NHB) and 1.13 in non-Hispanic Whites (NHW) (P < 0.0001). In multivariable linear regression analysis that adjusted for age, gender, ethnicity, smoking, height, diabetes, brachial SBP, dyslipidemia, diabetes, renal function, concurrent cardiovascular disease, and plasma levels of homocysteine, fibrinogen and C-reactive protein, NHB had lower ABI than NHW (β = - 0.03 ± 0.004, P < 0.00001). Although, NHBs had higher ankle SBP than NHWs (by 5.4 mm Hg), NHBs had a lower mean ankle SBP (β = - 3.663 mm Hg ± 0.500, P < 0.0001) after adjusting for clinical covariates, including brachial SBP, in multivariable analysis. Conclusion: Ethnic differences in ABI are present in middle-aged adults at low risk for peripheral atherosclerosis.
AB - Introduction: To better understand the basis for previously reported ethnic differences in ankle brachial index (ABI), we investigated whether these differences were present in individuals without known peripheral arterial disease (PAD). Methods: We used data from National Health and Nutrition Examination surveys (NHANES 1999-2004) to determine whether ethnic differences were present in respondents without PAD (1 ≤ ABI ≤ 1.3). We assessed whether ethnicity was an independent predictor of ABI and ankle systolic blood pressure (SBP) in linear regression models that adjusted for conventional and novel cardiovascular risk factors. To minimize effects of atherosclerosis on ABI, we studied adults aged ≤ 60 years, and also repeated our analyses in a subset aged ≤ 50 years that did not have risk factors for PAD. Results: 3348 participants aged ≤ 60 years were included in the study. Mean ABI was 1.11 in non-Hispanic Blacks (NHB) and 1.13 in non-Hispanic Whites (NHW) (P < 0.0001). In multivariable linear regression analysis that adjusted for age, gender, ethnicity, smoking, height, diabetes, brachial SBP, dyslipidemia, diabetes, renal function, concurrent cardiovascular disease, and plasma levels of homocysteine, fibrinogen and C-reactive protein, NHB had lower ABI than NHW (β = - 0.03 ± 0.004, P < 0.00001). Although, NHBs had higher ankle SBP than NHWs (by 5.4 mm Hg), NHBs had a lower mean ankle SBP (β = - 3.663 mm Hg ± 0.500, P < 0.0001) after adjusting for clinical covariates, including brachial SBP, in multivariable analysis. Conclusion: Ethnic differences in ABI are present in middle-aged adults at low risk for peripheral atherosclerosis.
KW - Ankle brachial index
KW - Ankle systolic pressure
KW - Ethnicity
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U2 - 10.1016/j.ijcard.2011.05.068
DO - 10.1016/j.ijcard.2011.05.068
M3 - Article
C2 - 21652099
AN - SCOPUS:84872485130
SN - 0167-5273
VL - 162
SP - 228
EP - 233
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -