title: Sex differences in the prevalence and clinical outcomes of subclinical peripheral artery disease in the Health, Aging, and Body Composition (Health ABC) study.
abstract: The objective of the study was to determine if there are sex-based differences in the prevalence and clinical outcomes of subclinical peripheral artery disease (PAD). We evaluated the sex-specific associations of ankle-brachial index (ABI) with clinical cardiovascular disease outcomes in 2797 participants without prevalent clinical PAD and with a baseline ABI measurement in the Health, Aging, and Body Composition study. The mean age was 74 years, 40% were black, and 52% were women. Median follow-up was 9.37 years. Women had a similar prevalence of ABI < 0.9 (12% women versus 11% men; P = 0.44), but a higher prevalence of ABI 0.9-1.0 (15% versus 10%, respectively; P < 0.001). In a fully adjusted model, ABI < 0.9 was significantly associated with higher coronary heart disease (CHD) mortality, incident clinical PAD and incident myocardial infarction in both women and men. ABI < 0.9 was significantly associated with incident stroke only in women. ABI 0.9-1.0 was significantly associated with CHD death in both women (hazard ratio 4.84, 1.53-15.31) and men (3.49, 1.39-8.72). However, ABI 0.9-1.0 was significantly associated with incident clinical PAD (3.33, 1.44-7.70) and incident stroke (2.45, 1.38-4.35) only in women. Subclinical PAD was strongly associated with adverse CV events in both women and men, but women had a higher prevalence of subclinical PAD.
authors.affiliation: Department of Surgery, University of California, San Francisco, CA.
authors.forename: Jade S
authors.initials: JS
authors.lastname: Hiramoto
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Christina
authors.initials: C
authors.lastname: Wassel
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.forename: B Gwen
authors.initials: BG
authors.lastname: Windham
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.forename: Anne
authors.initials: A
authors.lastname: Newman
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D001823:Body Composition; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D010414:Pennsylvania / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000401:mortality; D013714:Tennessee / Q000453:epidemiology; D013997:Time Factors
keywords: epidemiology; peripheral artery disease; sex-specific; women