دورية أكاديمية
أعرض في EDS

Ankle brachial index screening in asymptomatic older adults.

التفاصيل البيبلوغرافية
العنوان: Ankle brachial index screening in asymptomatic older adults.
المؤلفون: Taylor-Piliae RE; College of Nursing, University of Arizona, Tucson, 85721-0203, USA. rtaylor@nursing.arizona.edu, Fair JM, Varady AN, Hlatky MA, Norton LC, Iribarren C, Go AS, Fortmann SP
المصدر: American heart journal [Am Heart J] 2011 May; Vol. 161 (5), pp. 979-85.
نوع المنشور: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0370465 Publication Model: Print Cited Medium: Internet ISSN: 1097-6744 (Electronic) Linking ISSN: 00028703 NLM ISO Abbreviation: Am Heart J Subsets: MEDLINE
أسماء مطبوعة: Original Publication: St. Louis, MO : Mosby
مواضيع طبية MeSH: Ankle Brachial Index/*methods , Brachial Artery/*physiology , Mass Screening/*methods , Peripheral Arterial Disease/*diagnosis , Risk Assessment/*methods , Tibial Arteries/*physiology, Age Factors ; Aged ; Brachial Artery/diagnostic imaging ; California/epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Peripheral Arterial Disease/epidemiology ; Peripheral Arterial Disease/physiopathology ; Prevalence ; Prognosis ; Reference Values ; Retrospective Studies ; Risk Factors ; Tibial Arteries/diagnostic imaging ; Ultrasonography, Doppler
مستخلص: Background: Screening for peripheral arterial disease (PAD) by measuring ankle brachial index (ABI) in asymptomatic older adults is currently recommended to improve cardiovascular disease risk assessment and establish early treatment, but it is not clear if the strategy is useful in all populations. We examined the prevalence and independent predictors of an abnormal ABI (<0.90), in an asymptomatic sample of 1,017 adults, 60 to 69 years old, enrolled in the ADVANCE study.
Methods: Baseline data collected between December 2001 and January 2004 among the healthy older controls enrolled in ADVANCE was examined. Frequency distributions and prevalence estimates of an abnormal ABI were calculated, using both standard and modified definitions of ABI. Stepwise logistic regression was used to examine independent predictors of ABI <0.90. Signal detection analysis using recursive partitioning was employed to explore potential demographic and clinical variables related to ABI <0.90.
Results: The prevalence of ABI <0.90 was 2% when using the standard definition and 5% when using a modified definition. ABI prevalence did not differ by gender (P > .05). Compared with subjects who had a normal ABI (0.90-1.39), subjects with an ABI <0.90 were more likely to currently smoke, be physically inactive, have a coronary artery calcium score >10, and an FRS >20% (P ≤ .02). Independent predictors of ABI <0.90 when using the standard definition included currently smoking, physical inactivity, and body mass index >30 (all P values ≤.03), and when using the modified definition included currently smoking, physical inactivity, and hypertension (all P values ≤.04). Currently, smoking was the only significant variable for ABI <0.90 derived through recursive partitioning (P = .02), and indicated that prevalence of ABI <0.90 was 1.5% for nonsmokers, while it was 6.6% for current smokers.
Conclusions: ABI screening in generally healthy individuals 60 to 69 years old may result in lower prevalence rates of a positive result than estimates based on studies in clinical populations. The modified definition for calculating ABI captured more asymptomatic adults with suspected peripheral arterial disease. More evaluation of the appropriate role of ABI screening in unselected populations is needed before routine screening is implemented.
(Copyright © 2011 Mosby, Inc. All rights reserved.)
References: Ann Behav Med. 1998 Winter;20(1):1-6. (PMID: 9755345)
MMWR Morb Mortal Wkly Rep. 2005 Nov 11;54(44):1124-7. (PMID: 16280970)
J Vasc Interv Radiol. 2003 Sep;14(9 Pt 2):S389. (PMID: 14514853)
AJR Am J Roentgenol. 2002 Oct;179(4):825-31. (PMID: 12239019)
J Am Coll Cardiol. 2003 Jun 4;41(11):1906-17. (PMID: 12798557)
J Am Coll Cardiol. 2003 Jun 4;41(11):1886-98. (PMID: 12798555)
Circ J. 2008 Apr;72(4):605-10. (PMID: 18362433)
Circulation. 2009 Jan 27;119(3):e21-181. (PMID: 19075105)
Health Psychol. 1997 Jul;16(4):380-9. (PMID: 9237091)
Arterioscler Thromb Vasc Biol. 2005 Jul;25(7):1463-9. (PMID: 15879302)
JAMA. 2001 Sep 19;286(11):1317-24. (PMID: 11560536)
Am J Epidemiol. 2006 Sep 15;164(6):598-606. (PMID: 16840522)
J Am Board Fam Pract. 2005 Sep-Oct;18(5):355-61. (PMID: 16148245)
BMC Public Health. 2007;7:147. (PMID: 18293542)
J Am Coll Cardiol. 2008 Apr 1;51(13):1292-8. (PMID: 18371562)
Am J Cardiol. 2007 Sep 15;100(6):981-5. (PMID: 17826382)
Circulation. 2001 Oct 9;104(15):1863-7. (PMID: 11591627)
JAMA. 2008 Jul 9;300(2):197-208. (PMID: 18612117)
Clin J Oncol Nurs. 2006 Feb;10(1):73-6. (PMID: 16482730)
J Vasc Surg. 2006 Sep;44(3):531-6. (PMID: 16950430)
Circulation. 2006 Mar 21;113(11):e463-654. (PMID: 16549646)
Circulation. 2006 Aug 22;114(8):861-6. (PMID: 16923770)
WMJ. 2006 Sep;105(6):50-4. (PMID: 17042421)
Circulation. 2004 Feb 17;109(6):733-9. (PMID: 14970108)
Br J Gen Pract. 2007 Apr;57(537):311-5. (PMID: 17394735)
Int J Clin Pract. 2009 Jan;63(1):63-70. (PMID: 19125994)
Prev Cardiol. 2009 Spring;12(2):72-9. (PMID: 19476580)
Am Fam Physician. 2006 Feb 1;73(3):497-500. (PMID: 16477898)
Circulation. 2008 Aug 26;118(9):961-7. (PMID: 18697822)
J Manag Care Pharm. 2005 Nov-Dec;11(9):727-34. (PMID: 16300416)
Angiology. 2006 Mar-Apr;57(2):171-80. (PMID: 16518524)
Psychol Methods. 2001 Mar;6(1):35-48. (PMID: 11285811)
J Am Coll Cardiol. 2008 Jul 29;52(5):330-2. (PMID: 18652939)
Ann Intern Med. 2009 Oct 6;151(7):474-82. (PMID: 19805770)
معلومات مُعتمدة: T32 HL007034 United States HL NHLBI NIH HHS; 5T32 HL007034 United States HL NHLBI NIH HHS
تواريخ الأحداث: Date Created: 20110517 Date Completed: 20110721 Latest Revision: 20211020
رمز التحديث: 20240513
مُعرف محوري في PubMed: PMC4696757
DOI: 10.1016/j.ahj.2011.02.003
PMID: 21570532
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6744
DOI:10.1016/j.ahj.2011.02.003