American Journal of Epidemiology Vol. 129, No. 6: 1110-1119
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
PERIPHERAL ARTERIAL DISEASE IN LARGE VESSELS IS EPIDEMIOLOGICALLY DISTINCT FROM SMALL VESSEL DISEASE
AN ANALYSIS OF RISK FACTORS
1Department of Community and Family Medicine, University of California San Diego, School of Medicine, La Jolla, CA
2Department of Medicine, University of California San Diego, School of Medicine, La Jolla, CA
3Department of Surgery and Department of Bioengineering, University of California San Diego, School of Medicine, La Jolla, CA
Reprint requests to Dr. Michael H. Criqui, Division of Epidemiology, Department of Community and Family Medicine, M-007, University of California, San Diego, La Jolla, CA 92093
The authors used noninvasive techniques, including flow velocity by Doppler ultrasound, to accurately assess and distinguish between large and small vessel peripheral arterial disease in a population study in southern California, 1978–1981. In 565 men and women aged 38–82 years, there were 69 cases of large vessel peripheral arterial disease, 19 of which were severe, and 90 cases of isolated small vessel peripheral arterial disease. In cross-sectional multivariate analysis in men, large vessel peripheral arterial disease was significantly associated with age, pack-years of cigarettes smoked, systolic blood pressure, fasting plasma glucose, and marginally with obesity. Similar analysis in women revealed significant associations only for age and systolic blood pressure, although the associations for pack-years of cigarettes, obesity, and low density lipoprotein cholesterol were suggestive. By contrast, isolated small vessel peripheral arterial disease was not significantly associated with any of the major cardiovascular disease risk factors, including two measures of carbohydrate metabolism, fasting plasma glucose and glycosylated hemoglobin. These findings, coupled with our earlier report that large vessel peripheral arterial disease but not isolated small vessel peripheral arterial disease was independently predictive of subsequent mortality, suggest that large vessel peripheral arterial disease and isolated small vessel peripheral arterial disease are epidemiologically, as well as pathophysiologically, distinct entities.
blood pressure; glucose; lipids; lipoproteins; obesity; smoking; vascular diseases
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