Femoral atherosclerosis in an older British population: prevalence and risk factors

Most estimates of the prevalence of peripheral atherosclerosis have been ba sed on intermittent claudication or lower limb blood flow. The aim of this study was therefore to determine the prevalence of underlying femoral plaqu e, and to determine its association with other cardiovascular disease and r isk factors. Presence of plaque was identified using ultrasound in a random sample of men (n = 417) and women (n = 367) aged 56-77 years. Coexistent c ardiovascular disease, exercise and smoking were determined by questionnair e, blood pressure was recorded, and serum cholesterol and plasma fibrinogen were determined. Of the 784 subjects that were scanned, 502 (64%) demonstr ated atherosclerotic plaque. Disease prevalence increased significantly wit h age (P < 0.0001), and was more common in men (67.1 vs. 59.4%, P<0.05). Su bjects with femoral plaque had a significantly greater odds of previous isc haemic heart disease (OR 2.2, 95% CI 1.3, 3.7) and angina (OR 1.7, 95% CI 1 .03, 2.7), but not of stroke or leg pain on exercise. Current and ex-smokin g, raised serum total cholesterol and plasma fibrinogen levels, but not blo od pressure, were associated with an increased risk of femoral plaque, inde pendent of age and sex. Frequent exercise and a high HDL cholesterol were s ignificantly associated with lower risk. In conclusion, therefore, atherosc lerotic disease of the femoral artery affects almost two-thirds of the popu lation in late middle age. It is associated with an increased prevalence of ischaemic heart disease and angina, but whether detecting at risk individu als using ultrasound offers advantages over simpler and less expensive risk factor scoring requires evaluation in trials. (C) 2000 Elsevier Science Ir eland Ltd. All rights reserved.