TY - JOUR
T1 - Risk of peripheral artery disease according to race and sex
T2 - The Atherosclerosis Risk in Communities (ARIC) study
AU - Hicks, Caitlin W.
AU - Ding, Ning
AU - Kwak, Lucia
AU - Ballew, Shoshana H.
AU - Kalbaugh, Corey A.
AU - Folsom, Aaron R.
AU - Heiss, Gerardo
AU - Coresh, Josef
AU - Black, James H.
AU - Selvin, Elizabeth
AU - Matsushita, Kunihiro
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/5
Y1 - 2021/5
N2 - Background and aims: Previous community-based studies have demonstrated sex and race-based disparities in the risk of cardiovascular disease. We sought to examine the association of sex and race with incident peripheral artery disease (PAD-) and critical limb ischemia (CLI-) related hospitalizations. Methods: In 13,451 Black and White ARIC participants without prevalent PAD at baseline (1987–89), we estimated the cumulative incidence of PAD- and CLI-related hospitalization over a median follow-up of 26 years. We quantified hazard ratios (HRs) using Cox models across four sex- and race-groups. PAD and CLI were defined by hospitalization discharge codes. Results: The cumulative incidence of PAD-related hospitalization was higher in males than females in Whites (5.1% vs. 2.7%; p<0.001) but not in Blacks (5.7% vs. 5.0%; p=0.39). The cumulative incidence of CLI-related hospitalization differed significantly by race more than sex, occurring in 3.1% Black males, 3.1% Black females, 1.4% White males, and 0.8% White females (p<0.001). After risk factor adjustment, the risk of incident PAD-related hospitalization was similar for White males vs. White females [HR 1.14, 95%CI 0.90–1.45], and slightly higher for Black males [HR 1.26, 95%CI 0.92–1.72] and Black females [HR 1.39, 95%CI 1.03–1.87] compared to White females. The adjusted risk of incident CLI-related hospitalization was similar for White males vs. White females [HR 1.15, 95%CI 0.75–1.76], and significantly higher for Black males [HR 1.96, 95%CI 1.22–3.16] and Black females [HR 2.06, 95%CI 1.31–3.24] compared to White females. Conclusions: These data suggest that there are both sex- and race-specific patterns of PAD-related hospitalization that lead to differences in clinical disease risk and presentation.
AB - Background and aims: Previous community-based studies have demonstrated sex and race-based disparities in the risk of cardiovascular disease. We sought to examine the association of sex and race with incident peripheral artery disease (PAD-) and critical limb ischemia (CLI-) related hospitalizations. Methods: In 13,451 Black and White ARIC participants without prevalent PAD at baseline (1987–89), we estimated the cumulative incidence of PAD- and CLI-related hospitalization over a median follow-up of 26 years. We quantified hazard ratios (HRs) using Cox models across four sex- and race-groups. PAD and CLI were defined by hospitalization discharge codes. Results: The cumulative incidence of PAD-related hospitalization was higher in males than females in Whites (5.1% vs. 2.7%; p<0.001) but not in Blacks (5.7% vs. 5.0%; p=0.39). The cumulative incidence of CLI-related hospitalization differed significantly by race more than sex, occurring in 3.1% Black males, 3.1% Black females, 1.4% White males, and 0.8% White females (p<0.001). After risk factor adjustment, the risk of incident PAD-related hospitalization was similar for White males vs. White females [HR 1.14, 95%CI 0.90–1.45], and slightly higher for Black males [HR 1.26, 95%CI 0.92–1.72] and Black females [HR 1.39, 95%CI 1.03–1.87] compared to White females. The adjusted risk of incident CLI-related hospitalization was similar for White males vs. White females [HR 1.15, 95%CI 0.75–1.76], and significantly higher for Black males [HR 1.96, 95%CI 1.22–3.16] and Black females [HR 2.06, 95%CI 1.31–3.24] compared to White females. Conclusions: These data suggest that there are both sex- and race-specific patterns of PAD-related hospitalization that lead to differences in clinical disease risk and presentation.
KW - Critical limb ischemia
KW - Disparities
KW - Ethnicity
KW - Peripheral artery disease
KW - Race
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=85103678416&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103678416&partnerID=8YFLogxK
U2 - 10.1016/j.atherosclerosis.2021.03.031
DO - 10.1016/j.atherosclerosis.2021.03.031
M3 - Article
C2 - 33823370
AN - SCOPUS:85103678416
SN - 0021-9150
VL - 324
SP - 52
EP - 57
JO - Atherosclerosis
JF - Atherosclerosis
ER -