scholarly journals The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Aldo F. Costa ◽  
Mauricio Zambrano ◽  
Mark J. Sedler
Keyword(s):  
Logistic Regression ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Heart Association ◽  
Population Based ◽  
Community Dwelling ◽  
Peripheral Artery ◽  
Probability Models ◽  
High Prevalence ◽  
Artery Disease

Background. Information on the association between earlobe crease (ELC) and peripheral artery disease is limited. We assessed this association in community-dwelling older adults. Study Design. A total of 294 Atahualpa residents aged ≥60 years were enrolled. ELC were visually identified by two raters. The ankle-brachial index (ABI), used as a surrogate of peripheral artery disease, was categorized using American Heart Association criteria. Using logistic regression and probability models, adjusted for demographics and cardiovascular risk factors, we assessed the relationship between ELC and abnormal ABI determinations, as well as the influence of age on this association. Results. ELC was identified in 141 (48%) individuals, and abnormal ABI determination was carried out in 56 (19%). The association between ELC and abnormal ABI was nonsignificant in logistic regression and probability models with individuals stratified according to their median age. Conclusions. The association between ELC and abnormal ABI determinations is probably attenuated by the high prevalence of both conditions in older persons. ELC might not be useful for identifying candidates for ABI determination.

scholarly journals Peripheral artery disease impairs myocardial perfusion through increasing pulse wave reflection: the Northern Shanghai study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Yu ◽  
J Teliewubai ◽  
X Fan ◽  
C Chi ◽  
H Ji ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Peripheral Artery Disease ◽  
Wave Reflection ◽  
Pulse Wave ◽  
Ankle Brachial Index ◽  
Community Dwelling ◽  
Peripheral Artery ◽  
Cardiac Damage ◽  
Pulse Wave Reflection ◽  
Artery Disease

Abstract Background Peripheral artery disease (PAD) is prevalent and substantially contributes to cardiovascular mortality particularly in the elderly, although the pathophysiological impact of PAD on heart itself still needs further investigation. In theory, PAD can increase pulse wave reflection which is an important determinant of subendocardial viability ratio (SEVR), a valuable estimate of myocardial perfusion as indicated by previous invasive studies. Thus, we hypothesize that PAD impairs myocardial perfusion through increasing pulse wave reflection. In this study, we aim to test this hypothesis in a large cohort from the Northern Shanghai Study. Methods A total of 2947 community-dwelling elderly Chinese (43.6% male, mean age: 71.3±5.9 years) were recruited. Ankle-brachial index were measured with the VP1000 device and used to diagnose PAD. Pulse wave reflection was estimated as aortic augmentation pressure (AP). Aortic BP, AP and SEVR were assessed by radial applanation tonometry. Multiple linear regression with SEVR and AP as dependent variable and PAD as independent variable, meanwhile adjusted for other covariates, were performed, respectively. Results 375 (12.7%) participants presented PAD. Compared to subjects without PAD, those with PAD showed significantly lower SEVR (126 vs. 132, P<0.001) but higher AP (19 vs. 17 mmHg, P<0.001). Multiple regression analysis revealed that both SEVR (regression coefficient [B] = −1.69, P=0.04, R2=0.61) and AP (B=1.19, P=0.04, R2=0.56) significantly associated with PAD, respectively. However, the association between SEVR and PAD was abolished when further adjusted for AP (B=−0.49, P=0.52). Similar results were obtained when inter-leg systolic BP difference was used to diagnose PAD. Conclusions PAD significantly and independently associates with myocardial perfusion; moreover, this association is mediated by increased pulse wave reflection. These findings provide a new dimension for understanding the pathophysiological mechanisms of cardiac damage of PAD. Funding Acknowledgement Type of funding source: None

Abstract 91: Are At Risk Outpatient Cardiology Patients being Appropriately Evaluated for Lower Extremity PAD as Recommended by ACC/AHA Guidelines?

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Rajesh M Kabadi ◽  
Ankitkumar Patel ◽  
Rajani Sharma ◽  
Rita Schmidt ◽  
Elias Iliadis
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
High Risk ◽  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Heart Association ◽  
Low Risk ◽  
Peripheral Artery ◽  
Artery Disease

Background: Lower extremity peripheral artery disease (PAD) is a common syndrome that afflicts many individuals and leads to significant morbidity. Once appropriate at risk patients are identified, ankle-brachial index (ABI) testing is a relatively quick and inexpensive test that is recommended for proper assessment of PAD, per the recommendations outlined in the American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Peripheral Artery Disease (PAD) (JACC, 2006). Outpatient cardiology practices often take care of individuals at risk for PAD and have the opportunity to test and appropriately treat this condition. Methods: A randomly selected group of 367 outpatients seen in a large academic cardiology practice from September 2011 underwent retrospective chart review. Risk factors for PAD that were assessed include history of smoking, hypertension, diabetes, hyperlipidemia, homocysteine levels, and CRP. Those that had three or more risk factors were classified as high risk and those with less than that were classified as low risk and frequency of ABI testing was evaluated. Fishers exact test was utilized for statistical analysis. Results: Fifty-one percent (N=187) of our population were classified as high risk for PAD, forty-three percent (N=158) were low risk, and six percent (N=22) were known to already have PAD. Amongst the high risk individuals, only six percent (N=12) had ABI testing performed while there were three percent (N=6) of low risk individuals that had this test (p=-0.34). Conclusions: There was no difference in ABI testing between high and low risk populations. Limitations of this study include lack of information regarding other diagnostic modalities that may have been used in place of ABI testing. Quality improvement may be achieved by increased use of such testing as this would allow for quicker identification of the disease, prompter treatment, and better outcomes, at a minimal cost.

scholarly journals Prevalence, Correlates, and Prognosis of Peripheral Artery Disease in Rural Ecuador—Rationale, Protocol, andPhase IResults of a Population-Based Survey: An Atahualpa Project-Ancillary Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Oscar H. Del Brutto ◽  
Mark J. Sedler ◽  
Robertino M. Mera ◽  
Pablo R. Castillo ◽  
Elizabeth H. Cusick ◽  
...  
Keyword(s):  
Phase I ◽  
Peripheral Artery Disease ◽  
Cardiovascular Health ◽  
Ankle Brachial Index ◽  
Vascular Diseases ◽  
Population Based ◽  
Test Reliability ◽  
Phase Iii ◽  
Peripheral Artery ◽  
Artery Disease

Background. Little is known on the prevalence of peripheral artery disease (PAD) in developing countries.Study design. Population-based study in Atahualpa. InPhase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. InPhase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. InPhase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes.Results. DuringPhase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). A poor cardiovascular health status was noticed in 464 (70%) persons of which 27 (4%) had a stroke and 14 (2%) had ischemic heart disease. Forty-four subjects (7%) had suspected symptomatic PAD and 170 (26%) had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD.Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region.

scholarly journals Epidemiology of peripheral artery disease in Palestine

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 323-329
Author(s):  
Amal Jamee ◽  
Victor Aboyans ◽  
Julien Magne ◽  
Mohammed Elhendy ◽  
Pierre Marie Preux ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Arab Countries ◽  
Multivariate Logistic Regression Model ◽  
Peripheral Artery ◽  
High Prevalence ◽  
Artery Disease

Summary: Background: Peripheral artery disease (PAD) is one of the most common manifestations of atherosclerosis affecting more than 200 million people globally but little is known about its epidemiology in Middle East populations, particularly in Arab countries. The present study was undertaken to assess the prevalence of PAD in the general population aged 40 years and more in Gaza-Palestine, and to determine the prevalence of its associated risk factors. Patients and methods: The study design was a cross-sectional with a stratified proportional sampling, involving the five governorates in Gaza Strip. We selected 1490 individuals aged age ≥ 40 years living in the area for more than 3 years. The questionnaire on lifestyle and cardiovascular risk factors was applied and the ankle-brachial index (ABI) was measured by Doppler examination in both legs in all participants. PAD was defined as an ABI ≤ 0.90. We excluded 92 participants (6 %) because of missing ABI or ABI > 1.40. Results: One-half of the 1398 participants had at least two associated cardiovascular risk factors, one-third were on aspirin and 15 % on statins. Overall, we found PAD in 191 (13.7 %) cases. This prevalence increased with age, and 18.7 % of adults older than 65 years had PAD. The prevalence was higher in females than in males (respectively 15.6 % vs 11.6 % p = 0.031). In the multivariate logistic regression model, significant associated factors with PAD in males were CAD (OR: 3.5; 95 % CI: 1.4–8.6), hypertension (OR: 2.8; 95 % CI: 1.3–6.1), and current smoking (OR: 2.7; 95 % CI: 1.1–6.6). In women, hypertension remains the main associated risk factor. Conclusions: Our study highlights the high prevalence of PAD in the Gazan community, mostly related to the high prevalence of cardiovascular risk factors and other cardiovascular conditions.

scholarly journals Predictors of Peripheral Artery Disease among Elderly Respondents in an Urban Hospital, Edo State Nigeria

2021 ◽  
pp. 105-115
Author(s):  
Iboro Samuel Akpan ◽  
Ferguson Ayemere Ehimen ◽  
Babatunde Adedokun ◽  
Osaretin Oviasu
Keyword(s):  
Logistic Regression ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Sampling Technique ◽  
The Elderly ◽  
Urban Hospital ◽  
Peripheral Artery ◽  
Cross Sectional ◽  
Life Years ◽  
Artery Disease

Peripheral artery disease (PAD) potentially affects health-related Quality of Life, Disability Adjusted Life Years (DALYs) and is a strong prognostic marker for future cardiovascular events in elderly population. PAD commonly affects the elderly but may go undiagnosed in them, probably due to the presence of other morbidities like osteoarthritis and associated muscle spasm. Aim. The aim of this study was to determine the predictors of PAD in elderly by evaluating the socio-demographic and clinical characteristics in elderly patients. Methods. A cross sectional hospital based study was carried out among 370 patients aged 60 years and above attending a Tertiary Hospital from September to November 2017. A systematic random sampling technique was utilized. A structured questionnaire was administered to collect data on socio-demographic characteristics, lifestyle variables, and medical history. The Ankle Brachial Index (ABI) was used to assess for PAD. Analysis was done using Chi-square test and logistic regression.  Results. The mean age was 69.3±7 years comprising of 76.5% females, 50% of the respondents were married while 47% were widowed. After adjusting for other variables, the result of the multi-logistic regression indicated that only patients with abnormal pedal pulse were more likely to present with PAD than those with normal pedal pulse (OR=10.634, 95% CI=2.4-47.121, p=0.002). Conclusion. The study reveals that abnormal pedal pulses were significant predictors of PAD, therefore it is recommended that regular screening (clinical foot examination and ABI) should be done for elderly to achieve early detection of PAD and facilitate prompt treatment.

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