title: Self-reported peripheral arterial disease predicts future vascular events in a community-based cohort.
abstract: BACKGROUND
  Lower extremity peripheral arterial disease (PAD) is highly prevalent and strongly associated with cardiovascular morbidity and mortality. The ankle-brachial index used to screen for PAD is not routinely performed in primary care settings.
  
  
  OBJECTIVE
  To determine if self-reported PAD is an independent predictor of combined vascular events (myocardial infarction, ischemic stroke, and vascular death).
  
  
  METHODS
  Ongoing population-based prospective cohort (the Northern Manhattan Study). Subjects enrolled between July 1993 and June 2001 with a mean follow-up time of 7.1 years.
  
  
  METHODS
  Subjects (n = 2,977), aged 40 years or older and free of prior stroke or myocardial infarction, were classified as having self-reported PAD if they answered affirmatively to one of two questions regarding exercise-induced leg pain or a prior diagnosis of PAD.
  
  
  METHODS
  Combined vascular outcome defined as incident myocardial infarction, incident ischemic stroke, or vascular death.
  
  
  RESULTS
  The mean age of the cohort was 68.9 +/- 10.4 years; 64% were women; 54% Hispanic, 25% African-American, 21% Caucasian; 15% reported having PAD. After a mean follow-up of 7.1 years, self-reported PAD was significantly predictive of combined events (n = 484) in the univariate model (HR 1.5, 95% CI, 1.2-1.9) and after adjustment for traditional cardiovascular risk factors (HR 1.3, 95% CI, 1.0-1.7).
  
  
  CONCLUSIONS
  Self-reported PAD is an independent risk factor for future vascular events in this predominantly non-white cohort. The addition of two simple PAD questions to the routine medical history in general medicine settings could identify high-risk patients who would benefit from further vascular evaluation and risk factor modification.
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. ms3033@columbia.edu
authors.forename: Maya J
authors.initials: MJ
authors.lastname: Salameh
authors.forename: Tatjana
authors.initials: T
authors.lastname: Rundek
authors.forename: Bernadette
authors.initials: B
authors.lastname: Boden-Albala
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Ratchford
authors.forename: Marco R
authors.initials: MR
authors.lastname: Di Tullio
authors.forename: Shunichi
authors.initials: S
authors.lastname: Homma
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
mesh_terms: D000368:Aged; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications*