title: Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects.
abstract: OBJECTIVE
  This study sought to determine the relationship between vascular disease in different arterial territories and advanced age.
  
  
  BACKGROUND
  Vascular disease in the peripheral circulation is associated with significant morbidity and mortality. There is little data to assess the prevalence of different phenotypes of vascular disease in the very elderly.
  
  
  METHODS
  Over 3.6 million self-referred participants from 2003 to 2008 who completed a medical and lifestyle questionnaire in the United States were evaluated by screening ankle brachial indices <0.9 for peripheral artery disease (PAD), and ultrasound imaging for carotid artery stenosis (CAS) >50% and abdominal aortic aneurysm (AAA) >3 cm. Participants were stratified by decade of life. Multivariate logistic regression analysis was used to estimate odds of disease in different age categories.
  
  
  RESULTS
  Overall, the prevalence of PAD, CAS, and AAA, was 3.7%, 3.9%, and 0.9%, respectively. Prevalence of any vascular disease increased with age (40 to 50 years: 2%, 51 to 60 years: 3.5%, 61 to 70 years: 7.1%, 71 to 80 years: 13.0%, 81 to 90 years: 22.3%, 91 to 100 years: 32.5%; p < 0.0001). Prevalence of disease in each vascular territory increased with age. After adjustment for sex, race/ethnicity, body mass index, family history of cardiovascular disease, smoking, diabetes, hypertension, hypercholesterolemia, and exercise, the odds of PAD (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 2.12 to 2.15), CAS (OR: 1.80; 95% CI: 1.79 to 1.81), and AAA (OR: 2.33; 95% CI: 2.30 to 2.36) increased with every decade of life.
  
  
  CONCLUSIONS
  There is a dramatic increase in the prevalence of PAD, CAS, and AAA with advanced age. More than 20% and 30% of octogenarians and nonagenarians, respectively, have vascular disease in at least 1 arterial territory.
authors.affiliation: Department of Medicine, Division of Cardiology, School of Medicine, New York University, New York, New York 10016, USA.
authors.forename: Nazir
authors.initials: N
authors.lastname: Savji
authors.forename: Caron B
authors.initials: CB
authors.lastname: Rockman
authors.forename: Adam H
authors.initials: AH
authors.lastname: Skolnick
authors.forename: Yu
authors.initials: Y
authors.lastname: Guo
authors.forename: Mark A
authors.initials: MA
authors.lastname: Adelman
authors.forename: Thomas
authors.initials: T
authors.lastname: Riles
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Berger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology