Peripheral arterial disease in African Americans: clinical characteristics, leg symptoms, and lower extremity functioning.
OBJECTIVE
The describe peripheral arterial disease (PAD) in African Americans, and compare findings in African Americans and whites with PAD.


METHODS
Cross-sectional.


METHODS
Three academic medical centers.


METHODS
Three hundred sixty-six whites and 76 African Americans with PAD (as defined by an ankle brachial index (ABI) <0.90) aged 55 and older identified from lower extremity arterial studies performed between 1996 and the fall of 1999.


METHODS
Comprehensive medical interview, body mass index, and neuropathy score. Functional measurements included the 6-minute walk distance, 4-m walking velocity, and the summary performance score.


RESULTS
Age- and sex-adjusted results showed that African Americans had a lower mean ABI than whites (0.60 vs 0.66, P=.001), were less likely to be college graduates (13.7% vs 44.4%, P<.001), and had nearly twice the prevalence of diabetes mellitus (46.8% vs 28.0%, P=.001). After adjusting for age, sex, education level, and ABI, African Americans had a higher prevalence of no exertional leg pain (28.0% vs 18.2%, P=.044) and leg pain with exertion and rest (30.0% vs 17.3%, P=.023). African Americans had a shorter 6-minute walk distance (989 vs 1,156 ft, P<.001), a slower normal-pace 4-m walking velocity (0.79 vs 0.89 m/s, P<.001), a slower fast-pace 4-m walking velocity (1.12 vs 1.20 m/s, P=.012), and a lower summary performance score (8.8 vs 9.6, P=.018) than whites. These differences in functioning were attenuated after adjusting for age, sex, ABI, education, and leg symptoms.


CONCLUSIONS
Poorer lower extremity functioning in African Americans was largely explained by differences in leg symptoms and, to a somewhat lesser degree, lower ABI levels and poorer education in African Americans than in whites. Further study is needed to determine whether these findings affect racial treatment disparities and poorer outcomes previously reported in African Americans than in whites with PAD.
Rucker-Whitaker
Cheryl
C
Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois 60612, USA. cheryl_rucker-whitaker@rush.edu
Greenland
Philip
P
Liu
Kiang
K
Chan
Cheeling
C
Guralnik
Jack M
JM
Criqui
Michael H
MH
Taylor
Lloyd
L
Pearce
William H
WH
McGraeMcDermott
Mary
M
D001741:Black or African American; D000368:Aged; D000842:Ankle; D001794:Blood Pressure; D004522:Educational Status; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D004856:Postural Balance; D011674:Pulse; D016138:Walking; D044465:White People