PERIPHERAL ARTERY DISEASE AND CARDIOVASCULAR RISK-FACTORS IN THE ELDERLY - THE HONOLULU HEART PROGRAM

Peripheral vascular disease as measured by the ankle/brachial blood pr essure index (ABI) is associated with increased risk of mortality and morbidity. Few sources of data on the relationship of risk factors to ABI are available for the elderly, especially those >80 years of age, and minority populations. ABI measurements from the Honolulu Heart Pro gram's fourth reexamination of 3450 ambulatory, elderly Japanese Ameri can men indicate that the prevalence of an abnormal ABI, defined as a ratio of <0.9, was 13.6%, increasing from 8.0% in those 71 to 74 years of age to 27.4% in those 85 to 93 years. Associations that were U or J shaped were present for a number of risk factors (higher rates of ab normality [ABI<0.9] in those in the lowest and highest risk factor qui ntiles) in a cross-sectional analysis. Risk factors measured at baseli ne were also predictive of an abnormal ABI 25 years later, even after adjustment for multiple risk factors. The odds ratio (OR) for an ABI<0 .9 at the 80th percentile of cholesterol compared with that at the 20t h percentile was 1.4; the OR for 1-hour postload glucose was 1.3, and for alcohol intake 1.2. The OR associated with hypertension was 1.8 an d that for smoking, 2.9 (P<.05 for all ORs). These findings are consis tent with ABI being a marker for generalized atherosclerotic disease i n old and very old Japanese American men.