Savji N, Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, Berger JS, et al.
Journal of the American College of Cardiology. Date of publication 2013 Apr 23;volume 61(16):1736-43.
1. J Am Coll Cardiol. 2013 Apr 23;61(16):1736-43. doi: 10.1016/j.jacc.2013.01.054.
Epub 2013 Apr 2.
Association between advanced age and vascular disease in different arterial
territories: a population database of over 3.6 million subjects.
Savji N(1), Rockman CB, Skolnick AH, Guo Y, Adelman MA, Riles T, Berger JS.
Author information:
(1)Department of Medicine, Division of Cardiology, School of Medicine, New York
University, New York, New York 10016, USA.
OBJECTIVES: This study sought to determine the relationship between vascular
disease in different arterial territories and advanced age.
BACKGROUND: Vascular disease in the peripheral circulation is associated with
significant morbidity and mortality. There is little data to assess the
prevalence of different phenotypes of vascular disease in the very elderly.
METHODS: Over 3.6 million self-referred participants from 2003 to 2008 who
completed a medical and lifestyle questionnaire in the United States were
evaluated by screening ankle brachial indices <0.9 for peripheral artery disease
(PAD), and ultrasound imaging for carotid artery stenosis (CAS) >50% and
abdominal aortic aneurysm (AAA) >3 cm. Participants were stratified by decade of
life. Multivariate logistic regression analysis was used to estimate odds of
disease in different age categories.
RESULTS: Overall, the prevalence of PAD, CAS, and AAA, was 3.7%, 3.9%, and 0.9%,
respectively. Prevalence of any vascular disease increased with age (40 to 50
years: 2%, 51 to 60 years: 3.5%, 61 to 70 years: 7.1%, 71 to 80 years: 13.0%, 81
to 90 years: 22.3%, 91 to 100 years: 32.5%; p < 0.0001). Prevalence of disease in
each vascular territory increased with age. After adjustment for sex,
race/ethnicity, body mass index, family history of cardiovascular disease,
smoking, diabetes, hypertension, hypercholesterolemia, and exercise, the odds of
PAD (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 2.12 to 2.15), CAS (OR:
1.80; 95% CI: 1.79 to 1.81), and AAA (OR: 2.33; 95% CI: 2.30 to 2.36) increased
with every decade of life.
CONCLUSIONS: There is a dramatic increase in the prevalence of PAD, CAS, and AAA
with advanced age. More than 20% and 30% of octogenarians and nonagenarians,
respectively, have vascular disease in at least 1 arterial territory.
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier
Inc. All rights reserved.
DOI: 10.1016/j.jacc.2013.01.054
PMID: 23500290 [Indexed for MEDLINE]
