title: Mesenteric artery disease in the elderly.
abstract: OBJECTIVE
  The purpose of this study was to estimate the population-based prevalence of mesenteric artery stenosis (MAS) and occlusion among independent elderly Americans.
  
  
  METHODS
  As part of an ancillary investigation to the Cardiovascular Health Study (CHS), participants in the Forsyth County, NC cohort had visceral duplex sonography of the celiac arteries and superior mesenteric arteries (SMAs). Critical MAS was defined by celiac peak systolic velocity >or=2.0 m/s and/or SMA peak systolic velocity >or=2.7 m/s. Occlusion of either vessel was defined by lack of a Doppler-shifted signal within the imaged artery. Demographic data, blood pressures, and blood lipid levels were collected as part of the baseline CHS examination. Participants' weights were measured at baseline and before the duplex exam. Univariate tests of association were performed with two-way contingency tables, Student t tests, and Fisher exact tests. Multivariate associations were examined with logistic regression analysis.
  
  
  RESULTS
  A total of 553 CHS participants had visceral duplex sonography technically adequate to define the presence or absence of MAS. The study group had a mean age of 77.2 +/- 4.9 years and comprised 63% women and 37% men. Participant race was 76% white and 23% African-American. Ninety-seven participants (17.5%) had MAS. There was no significant difference in age, race, gender, body mass index, blood pressure, cholesterol, or low-density lipoproteins for participants with or without MAS. Forward stepwise variable selection found renal artery stenosis (P =.008; odds ratio [OR], 2.85; 95% confidence interval [CI], 1.31, 6.21) and high-density lipoprotein >40 (P =.02; OR, 3.03; 95% CI, 1.17, 7.81) significantly associated with MAS in a multivariate logistic regression model. Eighty-three of the 97 participants with MAS (15.0% of the cohort) had isolated celiac stenosis. Seven participants (1.3% of the cohort) had combined celiac and SMA stenosis. Five participants (0.9% of the cohort) had isolated SMA stenosis. Two participants (0.4% of the cohort) had celiac occlusion. Considering all participants with MAS, there was no association with weight change. However, SMA stenosis and celiac occlusion demonstrated an independent association with annualized weight loss (P =.028; OR, 1.54; 95% CI, 1.05, 2.26) and with renal artery stenosis (P =.001; OR, 9.48; 95% CI, 2.62, 34.47).
  
  
  CONCLUSIONS
  This investigation provides the first population-based estimate of the prevalence of MAS among independent elderly Americans. MAS existed in 17.5% of the study cohort. The majority had isolated celiac disease. SMA stenosis and celiac artery occlusion demonstrated a significant and independent association with weight loss and concurrent renal artery disease.
authors.affiliation: Division of Surgical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1095, USA. kjhansen@wfubmc.edu
authors.forename: Kimberley J
authors.initials: KJ
authors.lastname: Hansen
authors.forename: David B
authors.initials: DB
authors.lastname: Wilson
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Craven
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Pearce
authors.forename: William P
authors.initials: WP
authors.lastname: English
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Edwards
authors.forename: Juan
authors.initials: J
authors.lastname: Ayerdi
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Burke
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000150:complications; D002445:Celiac Artery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D015431:Weight Loss / Q000502:physiology