title: Femoral atherosclerosis in an older British population: prevalence and risk factors.
abstract: Most estimates of the prevalence of peripheral atherosclerosis have been based on intermittent claudication or lower limb blood flow. The aim of this study was therefore to determine the prevalence of underlying femoral plaque, and to determine its association with other cardiovascular disease and risk factors. Presence of plaque was identified using ultrasound in a random sample of men (n=417) and women (n=367) aged 56-77 years. Coexistent cardiovascular disease, exercise and smoking were determined by questionnaire, blood pressure was recorded, and serum cholesterol and plasma fibrinogen were determined. Of the 784 subjects that were scanned, 502 (64%) demonstrated atherosclerotic plaque. Disease prevalence increased significantly with age (P<0.0001), and was more common in men (67.1 vs. 59.4%, P<0.05). Subjects with femoral plaque had a significantly greater odds of previous ischaemic heart disease (OR 2. 2, 95% CI 1.3, 3.7) and angina (OR 1.7, 95% CI 1.03, 2.7), but not of stroke or leg pain on exercise. Current and ex-smoking, raised serum total cholesterol and plasma fibrinogen levels, but not blood pressure, were associated with an increased risk of femoral plaque, independent of age and sex. Frequent exercise and a high HDL cholesterol were significantly associated with lower risk. In conclusion, therefore, atherosclerotic disease of the femoral artery affects almost two-thirds of the population in late middle age. It is associated with an increased prevalence of ischaemic heart disease and angina, but whether detecting at risk individuals using ultrasound offers advantages over simpler and less expensive risk factor scoring requires evaluation in trials.
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, NW3 2PF, London, UK.
authors.forename: G C
authors.initials: GC
authors.lastname: Leng
authors.forename: O
authors.initials: O
authors.lastname: Papacosta
authors.forename: P
authors.initials: P
authors.lastname: Whincup
authors.forename: G
authors.initials: G
authors.lastname: Wannamethee
authors.forename: M
authors.initials: M
authors.lastname: Walker
authors.forename: S
authors.initials: S
authors.lastname: Ebrahim
authors.forename: A N
authors.initials: AN
authors.lastname: Nicolaides
authors.forename: S
authors.initials: S
authors.lastname: Dhanjil
authors.forename: M
authors.initials: M
authors.lastname: Griffin
authors.forename: G
authors.initials: G
authors.lastname: Belcaro
authors.forename: A
authors.initials: A
authors.lastname: Rumley
authors.forename: G D
authors.initials: GD
authors.lastname: Lowe
mesh_terms: D017677:Age Distribution; D000368:Aged; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D016001:Confidence Intervals; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D014463:Ultrasonography; D006113:United Kingdom / Q000453:epidemiology