Associations of lower-limb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: the Atherosclerosis Risk in Communities (ARIC) study
Associations of lower-limb atherosclerosis and arteriosclerosis with cardiovascular risk factors and disease in older adults: the Atherosclerosis Risk in Communities (ARIC) study
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 4330 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.
Conclusions: 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.
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Stone, Keeron
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Fryer, Simon
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Faulkner, James
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Meyer, Michelle L.
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Heffernan, Kevin
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Kucharska-Newton, Anna
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Zieff, Gabriel
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Paterson, Craig
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Matsushita, Kunihiro
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Hughes, Timothy M.
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Tanaka, Hirofumi
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Stoner, Lee
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22 December 2022
Stone, Keeron
d2ca8269-7990-40cd-888d-01ad8c6cfdd1
Fryer, Simon
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Faulkner, James
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Meyer, Michelle L.
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Heffernan, Kevin
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Kucharska-Newton, Anna
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Zieff, Gabriel
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Paterson, Craig
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Matsushita, Kunihiro
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Hughes, Timothy M.
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Tanaka, Hirofumi
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Stoner, Lee
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Stone, Keeron, Fryer, Simon, Faulkner, James, Meyer, Michelle L., Heffernan, Kevin, Kucharska-Newton, Anna, Zieff, Gabriel, Paterson, Craig, Matsushita, Kunihiro, Hughes, Timothy M., 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, .
(doi:10.1016/j.atherosclerosis.2021.10.014).
Abstract
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 4330 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.
Conclusions: 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.
Text
Stone. 2024. Aortic-femoral stiffness gradient and CVD risk_v5_merged
- Accepted Manuscript
Text
Stone. 2024. Online Supplements. Aortic-femoral stiffness gradient and CVD risk_v5
More information
Accepted/In Press date: 29 October 2021
e-pub ahead of print date: 3 November 2021
Published date: 22 December 2022
Identifiers
Local EPrints ID: 497488
URI: http://eprints.soton.ac.uk/id/eprint/497488
ISSN: 0021-9150
PURE UUID: cb878b92-68bb-487d-9f0d-9c2a89c44a24
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Date deposited: 23 Jan 2025 17:50
Last modified: 01 Feb 2025 05:01
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Contributors
Author:
Keeron Stone
Author:
Simon Fryer
Author:
James Faulkner
Author:
Michelle L. Meyer
Author:
Kevin Heffernan
Author:
Anna Kucharska-Newton
Author:
Gabriel Zieff
Author:
Craig Paterson
Author:
Kunihiro Matsushita
Author:
Timothy M. Hughes
Author:
Hirofumi Tanaka
Author:
Lee Stoner
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