Lifetime Risk of Lower-Extremity Peripheral Artery Disease Defined by Ankle-Brachial Index in the United States

Kunihiro Matsushita, Yingying Sang, Hongyan Ning, Shoshana Ballew, Eric K. Chow, Morgan Grams, Elizabeth Selvin, Matthew Allison, Michael Criqui, Josef Coresh, Donald M. Lloyd-Jones, John T. Wilkins

Research output: Contribution to journalArticle

Abstract

Background There are no available lifetime risk estimates of lower-extremity peripheral artery disease (PAD). Methods and Results Using data from 6 US community-based cohorts and the vital statistics, we estimated the prevalence and incidence of PAD, defined as an ankle-brachial index < 0.90, at each year of age from birth to 80 years for white, black, and Hispanic men and women. Then, we used Markov Monte Carlo simulations in a simulated cohort of 100 000 individuals to estimate lifetime risk of PAD. On the basis of odds ratios of PAD for traditional atherosclerotic risk factors (eg, diabetes mellitus and smoking), we developed a calculator providing residual lifetime risk of PAD. In an 80-year horizon, lifetime risks of PAD were 30.0% in black men and 27.6% in black women, but ≈19% in white men and women and ≈22% in Hispanic men and women. From another perspective, 9% of blacks were estimated to develop PAD by 60 years of age, while the same proportion was seen at ≈70 years for whites and Hispanics. The residual lifetime risk within the same race/ethnicity varied by 3.5- to 5-fold according to risk factors (eg, residual lifetime risk in 45-year-old black men was 19.9% when current smoking, diabetes mellitus, and history of cardiovascular disease were absent versus 70.4% when all were present). Conclusions In the United States, ≈30% of blacks are estimated to develop PAD during their lifetime, whereas the corresponding estimate is ≈20% for whites and Hispanics. The residual lifetime risk within the same race/ethnicity substantially varies according to traditional risk factors.

Original languageEnglish (US)
Pages (from-to)e012177
JournalJournal of the American Heart Association
Volume8
Issue number18
DOIs
StatePublished - Sep 17 2019

Fingerprint

Ankle Brachial Index
Peripheral Arterial Disease
Lower Extremity
Hispanic Americans
Diabetes Mellitus
Smoking
Vital Statistics
Cardiovascular Diseases
Odds Ratio
Parturition
Incidence

Keywords

  • epidemiology
  • peripheral artery disease
  • risk factor
  • risk score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lifetime Risk of Lower-Extremity Peripheral Artery Disease Defined by Ankle-Brachial Index in the United States. / Matsushita, Kunihiro; Sang, Yingying; Ning, Hongyan; Ballew, Shoshana; Chow, Eric K.; Grams, Morgan; Selvin, Elizabeth; Allison, Matthew; Criqui, Michael; Coresh, Josef; Lloyd-Jones, Donald M.; Wilkins, John T.

In: Journal of the American Heart Association, Vol. 8, No. 18, 17.09.2019, p. e012177.

Research output: Contribution to journalArticle

@article{a2ca5a577ec64de0b0742e250a1447d5,
title = "Lifetime Risk of Lower-Extremity Peripheral Artery Disease Defined by Ankle-Brachial Index in the United States",
abstract = "Background There are no available lifetime risk estimates of lower-extremity peripheral artery disease (PAD). Methods and Results Using data from 6 US community-based cohorts and the vital statistics, we estimated the prevalence and incidence of PAD, defined as an ankle-brachial index < 0.90, at each year of age from birth to 80 years for white, black, and Hispanic men and women. Then, we used Markov Monte Carlo simulations in a simulated cohort of 100 000 individuals to estimate lifetime risk of PAD. On the basis of odds ratios of PAD for traditional atherosclerotic risk factors (eg, diabetes mellitus and smoking), we developed a calculator providing residual lifetime risk of PAD. In an 80-year horizon, lifetime risks of PAD were 30.0{\%} in black men and 27.6{\%} in black women, but ≈19{\%} in white men and women and ≈22{\%} in Hispanic men and women. From another perspective, 9{\%} of blacks were estimated to develop PAD by 60 years of age, while the same proportion was seen at ≈70 years for whites and Hispanics. The residual lifetime risk within the same race/ethnicity varied by 3.5- to 5-fold according to risk factors (eg, residual lifetime risk in 45-year-old black men was 19.9{\%} when current smoking, diabetes mellitus, and history of cardiovascular disease were absent versus 70.4{\%} when all were present). Conclusions In the United States, ≈30{\%} of blacks are estimated to develop PAD during their lifetime, whereas the corresponding estimate is ≈20{\%} for whites and Hispanics. The residual lifetime risk within the same race/ethnicity substantially varies according to traditional risk factors.",
keywords = "epidemiology, peripheral artery disease, risk factor, risk score",
author = "Kunihiro Matsushita and Yingying Sang and Hongyan Ning and Shoshana Ballew and Chow, {Eric K.} and Morgan Grams and Elizabeth Selvin and Matthew Allison and Michael Criqui and Josef Coresh and Lloyd-Jones, {Donald M.} and Wilkins, {John T.}",
year = "2019",
month = "9",
day = "17",
doi = "10.1161/JAHA.119.012177",
language = "English (US)",
volume = "8",
pages = "e012177",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "18",

}

TY - JOUR

T1 - Lifetime Risk of Lower-Extremity Peripheral Artery Disease Defined by Ankle-Brachial Index in the United States

AU - Matsushita, Kunihiro

AU - Sang, Yingying

AU - Ning, Hongyan

AU - Ballew, Shoshana

AU - Chow, Eric K.

AU - Grams, Morgan

AU - Selvin, Elizabeth

AU - Allison, Matthew

AU - Criqui, Michael

AU - Coresh, Josef

AU - Lloyd-Jones, Donald M.

AU - Wilkins, John T.

PY - 2019/9/17

Y1 - 2019/9/17

N2 - Background There are no available lifetime risk estimates of lower-extremity peripheral artery disease (PAD). Methods and Results Using data from 6 US community-based cohorts and the vital statistics, we estimated the prevalence and incidence of PAD, defined as an ankle-brachial index < 0.90, at each year of age from birth to 80 years for white, black, and Hispanic men and women. Then, we used Markov Monte Carlo simulations in a simulated cohort of 100 000 individuals to estimate lifetime risk of PAD. On the basis of odds ratios of PAD for traditional atherosclerotic risk factors (eg, diabetes mellitus and smoking), we developed a calculator providing residual lifetime risk of PAD. In an 80-year horizon, lifetime risks of PAD were 30.0% in black men and 27.6% in black women, but ≈19% in white men and women and ≈22% in Hispanic men and women. From another perspective, 9% of blacks were estimated to develop PAD by 60 years of age, while the same proportion was seen at ≈70 years for whites and Hispanics. The residual lifetime risk within the same race/ethnicity varied by 3.5- to 5-fold according to risk factors (eg, residual lifetime risk in 45-year-old black men was 19.9% when current smoking, diabetes mellitus, and history of cardiovascular disease were absent versus 70.4% when all were present). Conclusions In the United States, ≈30% of blacks are estimated to develop PAD during their lifetime, whereas the corresponding estimate is ≈20% for whites and Hispanics. The residual lifetime risk within the same race/ethnicity substantially varies according to traditional risk factors.

AB - Background There are no available lifetime risk estimates of lower-extremity peripheral artery disease (PAD). Methods and Results Using data from 6 US community-based cohorts and the vital statistics, we estimated the prevalence and incidence of PAD, defined as an ankle-brachial index < 0.90, at each year of age from birth to 80 years for white, black, and Hispanic men and women. Then, we used Markov Monte Carlo simulations in a simulated cohort of 100 000 individuals to estimate lifetime risk of PAD. On the basis of odds ratios of PAD for traditional atherosclerotic risk factors (eg, diabetes mellitus and smoking), we developed a calculator providing residual lifetime risk of PAD. In an 80-year horizon, lifetime risks of PAD were 30.0% in black men and 27.6% in black women, but ≈19% in white men and women and ≈22% in Hispanic men and women. From another perspective, 9% of blacks were estimated to develop PAD by 60 years of age, while the same proportion was seen at ≈70 years for whites and Hispanics. The residual lifetime risk within the same race/ethnicity varied by 3.5- to 5-fold according to risk factors (eg, residual lifetime risk in 45-year-old black men was 19.9% when current smoking, diabetes mellitus, and history of cardiovascular disease were absent versus 70.4% when all were present). Conclusions In the United States, ≈30% of blacks are estimated to develop PAD during their lifetime, whereas the corresponding estimate is ≈20% for whites and Hispanics. The residual lifetime risk within the same race/ethnicity substantially varies according to traditional risk factors.

KW - epidemiology

KW - peripheral artery disease

KW - risk factor

KW - risk score

UR - http://www.scopus.com/inward/record.url?scp=85071974591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071974591&partnerID=8YFLogxK

U2 - 10.1161/JAHA.119.012177

DO - 10.1161/JAHA.119.012177

M3 - Article

C2 - 31500474

AN - SCOPUS:85071974591

VL - 8

SP - e012177

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 18

ER -