Ethnic differences in ankle brachial index are present in middle-aged individuals without peripheral arterial disease

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)228-233
Number of pages6
JournalInternational Journal of Cardiology
Volume162
Issue number3
DOIs
StatePublished - Jan 20 2013

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Ankle Brachial Index
Peripheral Arterial Disease
Blood Pressure
Ankle
Linear Models
Nutrition Surveys
Atherosclerosis
Arm
Homocysteine
Dyslipidemias
C-Reactive Protein
Fibrinogen
Cardiovascular Diseases
Smoking
Regression Analysis
Kidney

Keywords

  • Ankle brachial index
  • Ankle systolic pressure
  • Ethnicity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{b3d24245839944d3a1b54f29a2be4fe5,
title = "Ethnic differences in ankle brachial index are present in middle-aged individuals without peripheral arterial disease",
abstract = "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.",
keywords = "Ankle brachial index, Ankle systolic pressure, Ethnicity",
author = "Siddharth Singh and Bailey, {Kent R} and Kullo, {Iftikhar Jan}",
year = "2013",
month = "1",
day = "20",
doi = "10.1016/j.ijcard.2011.05.068",
language = "English (US)",
volume = "162",
pages = "228--233",
journal = "International Journal of Cardiology",
issn = "0167-5273",
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number = "3",

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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 Jan

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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DO - 10.1016/j.ijcard.2011.05.068

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VL - 162

SP - 228

EP - 233

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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