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Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects.

Abstract：

OBJECTIVES: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.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Savji N,Rockman CB,Skolnick AH,Guo Y,Adelman MA,Riles T,Berger JS

doi

10.1016/j.jacc.2013.01.054

subject

Has Abstract

pub_date

2013-04-23 00:00:00

pages

1736-43

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(13)00695-5

journal_volume

pub_type

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Association between advanced age and vascular disease in different arterial territories: a population database of over 3.6 million subjects.