Prevalence and risk factors of peripheral arterial diseases in male Chinese octogenarians and nonagenarians with hypertension.

OBJECTIVE: To investigate the prevalence and risk factors of peripheral arterial disease (PAD) in male Chinese octogenarians and nonagenarians with hypertension. METHODS: Ankle-brachial index (ABI) was measured in the noninvasive vascular laboratory for hypertensive male octogenarians and nonagenarians enrolled from outpatient and inpatient departments. The baseline conditions were investigated using standard questionnaire and by routine physical examinations. PAD was diagnosed when an ABI≤0.9 in either lower extremity. RESULTS: Totally 290 male Chinese octogenarians and nonagenarians [age: (84.61±4.20) years] with hypertension who were receiving antihypertensive therapy were enrolled in this study, among whom 9 men with missing data except age and ABI measurements. The ABI was 0.948±0.258, with the range of highest frequency of 0.91-1.30, and 106 patients were diagnosed as PAD, 182 as non-PAD, and 2 had ABI>1.3. ABI in hypertensive men with PAD were significantly lower than in those without PAD (P<0.05). On the contrary, age, blood urea nitrogen, white blood cell counts, platelets and aspartic transaminase were significantly higher in PAD patients than in non-PAD patients (all P<0.05). The prevalence of PAD in this study population were 36.5%; more specifically, it significantly differed between different subgroups when stratified by age (28.6% vs. 46.3%, below and above 85 years), with and without hypertension (27.5% vs. 40.1%), stroke (44.7% vs. 27.5%), dyslipidemia (41.4% vs. 33.3%), coronary artery disease (44.1% vs. 13.9%), and diabetes mellitus (53.7% vs. 21.8%) (all P<0.05). The prevalences of PAD in hypertensive patients treated with diuretics, calcium antagonists, beta-blocker, or angiotensin receptor antagonist were 41.4%, 36.1%, 22.4%, and 26.8%, respectively. No association was observed between the prevalence of PAD and smoking/alcohol drinking in these subjects. Multivariate analysis showed that age (OR 1.12, 95%CI 1.014-1.238), blood urea nitrogen (OR 1.15, 95%CI 1.025-1.301), aspartic transaminase (OR 1.05, 95%CI 1.005-1.089), diabetes mellitus (OR 4.02, 95%CI 1.797-9.009), coronary artery disease (OR 6.34, 95%CI 1.734-23.214) were strong risk factors of PAD. CONCLUSION: PAD is highly prevalent among aged Chinese hypertensive men, in which age, blood urea nitrogen, aspartic transaminase, diabetes mellitus, coronary artery disease may be involved in the development of this condition.

Association of ankle-brachial index with clinical coronary heart disease, stroke in aged Chinese hypertensive men / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To assess the clinical significance of ankle-brachial index(ABI) in aged Chinese hypertensive men and to determine the association of ABI with clinical coronary heart disease, stroke.</p><p><b>METHODS</b>Ankle-brachial index (ABI) was measured by means of peripheral vascular lab in aged hypertensive men from 301 Hospital and Anzhen Hospital while the clinical characteristics of the study population were investigated and collected. ABI < or = 0.9 was defined as peripheral arterial disease (PAD), 1.01 - 1.30 as borderline PAD.</p><p><b>RESULTS</b>There were 244 aged Chinese hypertensive men with antihypertensive treatment and with mean age 76.47 +/- 9.75 enrolled in this study, in whom 15 men with missing data except general information and ABI measurement. The mean ABI was 0.941 +/- 0.258 with the highest frequency 1.01 - 1.30. Eighty five men were diagnosed as PAD, 22 as borderline PAD, 135 normal ABI and 2 with ABI > 1.3. ABI and rate of hypertension control in PAD and borderline PAD men were significantly lower than those with normal ABI. In both PAD and borderline PAD patients, the hypertension duration (except in borderline PAD), creatinine level, neutrophil count (except in borderline PAD), percentage of alcohol drinking, prevalence of diabetes mellitus (except in borderline PAD), coronary artery disease, stroke and dyslipidemia (except in borderline PAD) were significantly higher than those with normal ABI patients. The prevalences of PAD, borderline PAD, coronary artery disease and stroke in this study population were 35.1%, 9.1%, 64.0%, 40.5%, respectively. The prevalences of PAD, borderline PAD, coronary artery disease and stroke increased significantly with increasing age. Logistic regression analysis showed that lower ABI was inversely associated with clinical coronary artery disease and stroke after adjustment for age, body mass index, hypertension duration, rate of hypertension control, systolic blood pressure, diastolic blood pressure, status of smoking, alcohol drinking, diabetes mellitus, dyslipidemia. The fully-adjusted odds ratios (ORs) for PAD and borderline PAD group compared with normal ABI group for the prevalence of coronary artery disease, and stroke demonstrated that these conditions were conversely related to ABI.</p><p><b>CONCLUSION</b>Aged hypertensive men have high prevalence of PAD. Low ABI level was independently associated with coronary artery disease and stroke.</p>