Ethnicity and risk factors for change in the ankle-brachial index: The Multi-Ethnic Study of Atherosclerosis

• Published in: Journal of vascular surgery 2009-11, Vol.50 (5), p.1049-1056
• Main Authors: Allison, Matthew A., MD, MPH, Cushman, Mary, MD, MS, Solomon, Cam, PhD, Aboyans, Victor, MD, PhD, McDermott, Mary M., MD, Goff, David C., MD, PhD, Criqui, Michael H., MD, MPH
• Format: Article
• Language: English
• Subjects: African Continental Ancestry Group; Age Factors; Aged; Aged, 80 and over; Ankle; Ankle - blood supply; Asian Continental Ancestry Group; Asian People - statistics & numerical data; Atherosclerosis; Atherosclerosis - ethnology; Atherosclerosis - etiology; Atherosclerosis - physiopathology; Biological and medical sciences; Black or African American; Black People - statistics & numerical data; Blood Pressure; Body Mass Index; Brachial Artery; Brachial Artery - physiopathology; Diabetes Complications; Diabetes Complications - ethnology; Diabetes Complications - etiology; Diabetes Complications - physiopathology; Disease Progression; European Continental Ancestry Group; Female; Health Status Disparities; Health Surveys; Hispanic Americans; Hispanic or Latino - statistics & numerical data; Humans; Hyperhomocysteinemia; Hyperhomocysteinemia - complications; Hyperhomocysteinemia - ethnology; Hyperhomocysteinemia - physiopathology; Hypertension; Hypertension - complications; Hypertension - etiology; Hypertension - physiopathology; Life Sciences; Logistic Models; Male; Medical sciences; Middle Aged; Neurology; Odds Ratio; Prospective Studies; Risk Assessment; Risk Factors; Santé publique et épidémiologie; Sex Factors; Smoking; Smoking - adverse effects; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Vascular diseases and vascular malformations of the nervous system; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; White People - statistics & numerical data
• ISSN: 0741-5214; 1097-6809; 1097-6809
• DOI: 10.1016/j.jvs.2009.05.061

Background The aim of this study was to determine the risk factors for conversion from a normal to either a low or high ankle-brachial index (ABI). Methods Participants in the Multi-Ethnic Study of Atherosclerosis who had two separate measurements of the ABI over a 3-year time period were assessed. Results At baseline, the mean age was 62 years and 50% were women, 28% African American, 12% Chinese, 22% Hispanic and 38% non-Hispanic White. Of the 5514 participants with a baseline ABI between 0.90 and 1.40, 89 (1.6%) had an ABI ≤ 0.90 (“low ABI group”) and 71 (1.3%) had an ABI ≥ 1.40 (“high ABI group”) 3 years later. On multivariable analysis, the odds for having progressed into the low ABI group were significantly increased for higher baseline age, hypertension, diabetes, greater pack-years of cigarette smoking, and homocysteine levels. The odds for progression into the high ABI group were increased for male gender and higher body mass index. Compared with non-Hispanic Whites, African Americans had a significantly higher odds for progression to the low ABI group (odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.29-3.88) while having a reduced odds for progression to the high ABI group (OR: 0.50, 95% CI: 0.24-1.00). Neither Chinese nor Hispanic ethnicity was significantly associated with progression to either ABI group. Conclusions The risk factors for progression to a low or high ABI were distinct and African Americans were at increased risk for progression to a low ABI but at decreased risk for progression into the high ABI group.