MiscellaneousRelation of Inflammation to Peripheral Arterial Disease in the National Health and Nutrition Examination Survey, 1999–2002
Section snippets
Study participants
The National Health and Nutrition Examination Survey (NHANES) 1999–2002 was a nationally representative sample of the United States noninstitutionalized, civilian population. As described in detail on the Web site of the National Center for Health Statistics,1 NHANES 1999–2002 included the oversampling of non-Hispanic blacks and Mexican Americans to provide stable estimates for these groups. Ankle-brachial index (ABI) measurements were obtained on the subsample of patients aged ≥40 years.
ABI measurement and PAD definition
For
Results
The mean ABI was 1.10 (SE 0.003), and the prevalence of PAD (ABI <0.9) was 4.90% (SE 0.33). Patients in lower ABI categories were more likely to have a number of traditional cardiovascular disease risk factors (Table 1). Additionally, geometric mean CRP, fibrinogen, and leukocyte count were incrementally greater with each successively lower ABI category.
Graded, positive associations were present between quartiles of all 3 inflammatory markers and PAD prevalence (Figure 1). Associations remained
Discussion
These data provide evidence of strong, graded, positive associations between inflammation and PAD. Even after adjustment for traditional cardiovascular disease risk factors, patients in the highest quartile of CRP, fibrinogen, or leukocyte count had approximately 2 times greater odds of having PAD than those in the lowest quartile. Additionally, these data showed inflammation to maintain a stronger association with PAD in non-Hispanic blacks, current smokers, and middle-aged patients.
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Drs. Wildman and Chen received partial support for the analysis and interpretation of these data from the National Institutes of Health, Bethesda, Maryland (Grant 1 K12 HD43451-01).