Self-reported peripheral arterial disease predicts future vascular events in a community-based cohort

Maya J. Salameh, Tatjana Rundek, Bernadette Boden-Albala, Zhezhen Jin, Elizabeth V. Ratchford, Marco R. Di Tullio, Shunichi Homma, Ralph L Sacco

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings. OBJECTIVE: To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death). DESIGN: Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years. PATIENTS: Subjects (n=2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD. MAIN OUTCOME MEASURES: Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death. RESULTS: The mean age of the cohort was 68.9±10.4 years; 64% were women; 54% Hispanic, 25% African-American, 21% Caucasian; 15% reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n=484) in the univariate model (HR 1.5, 95% CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95% CI, 1.0-1.7). CONCLUSION: Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.

Original languageEnglish
Pages (from-to)1423-1428
Number of pages6
JournalJournal of General Internal Medicine
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2008

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Peripheral Arterial Disease
Blood Vessels
Stroke
Myocardial Infarction
Ankle Brachial Index
Hispanic Americans
African Americans
Lower Extremity
Primary Health Care
Leg
Medicine
Exercise
Morbidity
Pain
Mortality

Keywords

  • Claudication
  • Ischemic stroke
  • Myocardial infarction
  • Peripheral arterial disease
  • Vascular events

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Self-reported peripheral arterial disease predicts future vascular events in a community-based cohort. / Salameh, Maya J.; Rundek, Tatjana; Boden-Albala, Bernadette; Jin, Zhezhen; Ratchford, Elizabeth V.; Di Tullio, Marco R.; Homma, Shunichi; Sacco, Ralph L.

In: Journal of General Internal Medicine, Vol. 23, No. 9, 01.09.2008, p. 1423-1428.

Research output: Contribution to journalArticle

Salameh, Maya J. ; Rundek, Tatjana ; Boden-Albala, Bernadette ; Jin, Zhezhen ; Ratchford, Elizabeth V. ; Di Tullio, Marco R. ; Homma, Shunichi ; Sacco, Ralph L. / Self-reported peripheral arterial disease predicts future vascular events in a community-based cohort. In: Journal of General Internal Medicine. 2008 ; Vol. 23, No. 9. pp. 1423-1428.
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abstract = "BACKGROUND: Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings. OBJECTIVE: To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death). DESIGN: Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years. PATIENTS: Subjects (n=2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD. MAIN OUTCOME MEASURES: Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death. RESULTS: The mean age of the cohort was 68.9±10.4 years; 64{\%} were women; 54{\%} Hispanic, 25{\%} African-American, 21{\%} Caucasian; 15{\%} reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n=484) in the univariate model (HR 1.5, 95{\%} CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95{\%} CI, 1.0-1.7). CONCLUSION: Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.",
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AU - Salameh, Maya J.

AU - Rundek, Tatjana

AU - Boden-Albala, Bernadette

AU - Jin, Zhezhen

AU - Ratchford, Elizabeth V.

AU - Di Tullio, Marco R.

AU - Homma, Shunichi

AU - Sacco, Ralph L

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AB - BACKGROUND: Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings. OBJECTIVE: To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death). DESIGN: Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years. PATIENTS: Subjects (n=2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD. MAIN OUTCOME MEASURES: Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death. RESULTS: The mean age of the cohort was 68.9±10.4 years; 64% were women; 54% Hispanic, 25% African-American, 21% Caucasian; 15% reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n=484) in the univariate model (HR 1.5, 95% CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95% CI, 1.0-1.7). CONCLUSION: Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.

KW - Claudication

KW - Ischemic stroke

KW - Myocardial infarction

KW - Peripheral arterial disease

KW - Vascular events

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