Peripheral arterial disease in large vessels is epidemiologically distinct from small vessel disease: An analysis of risk factors

Michael H. Criqui, Deirdre Browner, Arnost Fronek, Melville R. Klauber, Steven S. Coughlin, Elizabeth Barrett-connor, Sam Gabriel

Research output: Contribution to journalArticlepeer-review

138 Scopus citations

Abstract

The authors used noninvasive techniques, including flow velocity by Doppler ultrasound, to accurately assess and distinguish between large and small vessel peripheral arterial disease in a population study in southern California, 1978-1981. In 565 men and women aged 38-82 years, there were 69 cases of large vessel peripheral arterial disease, 19 of which were severe, and 90 cases of isolated small vessel peripheral arterial disease. In cross-sectional multivariate analysis in men, large vessel peripheral arterial disease was significantly associated with age, pack-years of cigarettes smoked, systolic blood pressure, fasting plasma glucose, and marginally with obesity. Similar analysis in women revealed significant associations only for age and systolic blood pressure, although the associations for pack-years of cigarettes, obesity, and low density lipoprotein cholesterol were suggestive. By contrast, isolated small vessel peripheral arterial disease was not significantly associated with any of the major cardiovascular disease risk factors, including two measures of carbohydrate metabolism, fasting plasma glucose and glycosylated hemoglobin. These findings, coupled with our earlier report that large vessel peripheral arterial disease but not isolated small vessel peripheral arterial disease was independently predictive of subsequent mortality, suggest that large vessel peripheral arterial disease and isolated small vessel peripheral arterial disease are epidemiologically, as well as pathophysiologically, distinct entities.

Original languageEnglish (US)
Pages (from-to)1110-1119
Number of pages10
JournalAmerican journal of epidemiology
Volume129
Issue number6
DOIs
StatePublished - Jun 1989
Externally publishedYes

Keywords

  • Blood pressure
  • Glucose
  • Lipids
  • Lipoproteins
  • Obesity
  • Smoking
  • Vascular diseases

ASJC Scopus subject areas

  • General Medicine

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