title: Prevalence of lower extremity peripheral arterial disease in individuals with chronic immune mediated inflammatory disorders.
abstract: OBJECTIVE
  To compare the prevalence of lower extremity peripheral artery disease (PAD) and to assess whether age-associated progression in ankle-brachial index (ABI) differs between individuals with chronic immune-mediated inflammatory diseases (CIID) and the general population.
  
  
  METHODS
  Pooled analysis with data from individuals aged 50 years and older with ABI measurements, obtained from population-based cross-sectional studies conducted in Catalonia (Spain). Information on three CIID diagnoses (i.e., inflammatory bowel disease, systemic connective tissue disorders, and inflammatory polyarthropathies and spondylopathies, considered as one entity for purposes of analysis) was obtained from electronic medical records. To ascertain the statistical association between PAD and CIID, logistic regression models were fitted and adjusted for age, sex, and cardiovascular risk factors. We tested the interaction between age and CIID diagnosis for ABI values.
  
  
  RESULTS
  We included 8799 individuals, 312 (3.6%) with CIID. The age-standardized prevalence of PAD was higher in the CIID group (12% vs. 6% in general population, p = 0.001), and the model adjusted for age, sex, and cardiovascular risk factors also showed higher risk in individuals with CIID [Odds Ratio (95% confidence interval) = 1.65 (1.15-2.38); p = 0.007]. The inflammatory polyarthropathies/spondylopathies diagnosis was significantly associated with PAD in the fully adjusted model [1.80 (1.18-2.75); p = 0.006]. The atherosclerotic process was accelerated in individuals with CIID, compared to the general population (p for interaction<0.001).
  
  
  CONCLUSIONS
  In individuals with CIID, age-standardized prevalence of PAD was significantly higher than in the general population and the atherosclerotic process was accelerated. However, only inflammatory polyarthropathies/spondylopathies was associated with significant risk of PAD.
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Infectious Diseases Service, Hospital Clinic - IDIBAPS, University of Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Agüero
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; L'Anoia Health Consortium, Igualada, Barcelona, Spain; Pompeu-Fabra University, Barcelona, Spain.
authors.forename: Griselda
authors.initials: G
authors.lastname: González-Zobl
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; La Marina Primary Care Centre, Barcelona, Spain; CIBER Epidemiology and Public Health, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Baena-Díez
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Irene R
authors.initials: IR
authors.lastname: Dégano
authors.affiliation: Research Unit of Family Medicine Girona, Primary Care Research Institute Jordi Gol, Girona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Garcia-Gil
authors.affiliation: Riu Nord-Riu Sud Primary Care Centre Santa Coloma de Gramenet, Barcelona, Spain; Research Unit Metropolitana Nord, Primary Care Research Institute Jordi Gol, Santa Coloma de Gramenet, Barcelona, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Alzamora
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.affiliation: Research Unit of Family Medicine Girona, Primary Care Research Institute Jordi Gol, Girona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Comas-Cufí
authors.affiliation: Research Unit Metropolitana Nord, Primary Care Research Institute Jordi Gol, Santa Coloma de Gramenet, Barcelona, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Pera
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
authors.affiliation: Research Unit of Family Medicine Girona, Primary Care Research Institute Jordi Gol, Girona, Spain.
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos
authors.affiliation: Cardiovascular Epidemiology and Genetics, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. Electronic address: mgrau@imim.es.
authors.forename: María
authors.initials: M
authors.lastname: Grau
mesh_terms: D000368:Aged; D000375:Aging; D055109:Ankle Brachial Index; D001168:Arthritis / Q000453:epidemiology* / Q000276:immunology; D001327:Autoimmune Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003240:Connective Tissue Diseases / Q000453:epidemiology* / Q000276:immunology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004198:Disease Susceptibility; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000276:immunology; D007383:Intermittent Claudication / Q000453:epidemiology; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D025242:Spondylarthropathies / Q000453:epidemiology* / Q000276:immunology; D011795:Surveys and Questionnaires
keywords: Ankle brachial index; Connective tissue disorders; Epidemiology; Inflammatory bowel disease; Peripheral artery disease; Rheumatic diseases; Spondylopathies