title: Peripheral arterial disease among substance abusers in drug treatment.
abstract: OBJECTIVE
  Examine the occurrence of and risk factors for peripheral arterial disease (PAD) in a sample in drug treatment.
  
  
  METHODS
  Cross-sectional/stratified design.
  
  
  METHODS
  Ten methadone treatment centers in a large Midwestern metropolitan area in the United States.
  
  
  METHODS
  Six hundred forty participants (290 men [45.3%]; mean [SD] age, 46.54 years [8.85 years]) were included in the study. Sixty-one percent were African American, and 93.5% had a history of smoking cigarettes.
  
  
  METHODS
  PAD was defined as an ankle brachial index of less than 0.90 in at least 1 leg. Measures included demographic, health, and illicit drug use history questionnaires; the Walking Impairment Questionnaire; and body mass index. The Positive Attitude Toward Physical Activities/Exertion Questionnaire was added 9 months into the study; this decreased the sample size of the logistic regression for the predictors of PAD to 498.
  
  
  RESULTS
  PAD was identified in 16.7% of the sample; the mean ankle brachial index value for persons with PAD was 0.84 (SD, 0.05). Multiple logistic regression analysis found that sex (women) (odds ratio [OR], 2.10), history of ever smoking cigarettes (OR, 5.16), years of smoking cigarettes (OR, 1.60 per 10 years' smoking), and having a positive attitude toward physical activities/exertion (OR, 0.63) made significant contributions to the predictors for PAD after controlling other background and risk variables.
  
  
  CONCLUSIONS
  PAD is prevalent in persons undergoing drug treatment and is best accounted for by cigarette smoking, sex differences, and physical inactivity. PAD in drug abusers should be evaluated, and the current findings merit further investigation.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Pieper
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Birk
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology