Peripheral vascular disease: consequence for survival and association with risk factors in the Speedwell prospective heart disease study.

Bainton, David; Sweetnam, P. M.; Baker, Ian; Elwood, Peter Creighton

doi:10.1136/hrt.72.2.128

Cited by 129 publications

(82 citation statements)

References 12 publications

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“…26,27 The discrepancy may be related to the higher prevalence of PAD in elderly males and in smokers; elderly males show a weaker relationship between obesity and CVD, and smokers tend to have lower BMI than non-smokers. 28 A recent prospective cohort study revealed a positive relationship between waist-to-hip ratio, not BMI, and PAD prevalence.…”

Section: Peripheral Arterial Disease (Pad)mentioning

confidence: 96%

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Shimabukuro

2009

Circ J

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he obesity epidemic is a global public health concern that threatens to reduce life expectancy around the world. 1,2 Excess weight, particularly abdominal obesity, causes or exacerbates cardiovascular and metabolic risk factors, including hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM). [3][4][5] These risk factors synergistically increase the likelihood of morbidity and mortality of cardiovascular disease (CVD), 6,7 which leads to rising healthcare costs. 8 Actions promoting health check-ups for obesity-related conditions and prevention strategies have been proposed; 9 however, the theoretical background has not been fully coordinated, and, most importantly, the actions to reduce abdominal adiposity has not been fully validated in terms of global cardiovascular risk management. The contribution of abdominal obesity to global cardiometabolic risk will be reviewed and the potential, underlying mechanisms and management strategy will be also discussed. Contribution of Abdominal Obesity to CVDRecent studies show that waist circumference is directly related to all-cause mortality when adjusted for body mass index (BMI), 6 and is also strongly associated with the mortality and morbidity of CVD. 7 The facts highlight the importance of visceral fat over subcutaneous fat deposits and promote the incorporation of waist circumference into the diagnosis of metabolic syndrome (MetS). 3-5 Each entity of CVD will be discussed below. Coronary Heart Disease (CHD)In the landmark INTERHEART study, 10 Yusuf et al reported the effect of various measures of adiposity on rates of acute myocardial infarction (AMI) by comparing 12,461 AMI cases and 14,637 standardized controls of varying ethnicity from 52 countries. BMI showed a modest association with AMI (unadjusted odds ratio (OR) 1.44 for 1 st vs 5 th quintile), but this association was lost after adjustment for other risk factors. Meanwhile, the adjusted OR for quintile of the waist-to-hip ratio was successively greater than that of the previous one (OR 1.15, 1.39, 1.90, and 2.52, respectively). Waist-to-hip ratio, and the waist and hip circumferences were highly associated with the risk of AMI, even after adjustment for other risk factors (OR for 1 st vs 5 th quintiles, 1.75, 1.33, and 0.76, respectively; P<0.0001). More recently, investigators in the EPIC-Norfolk study reported that waist circumference, but not BMI, was a significant estimate for all CHD events during 9.1 years and that hip circumference appeared to protect against CHD. 11 Taken together, a redefinition of obesity based on waist circumference, instead of BMI, is a better estimate of CHD in most ethnic groups, and the notion can be supported that abdominal adiposity, not subcutaneous adiposity, is closely linked to the onset of CHD. The presence of MetS appears to be associated with worse outcomes in patients with AMI 12 or in patients following coronary artery bypass surgery. 13 In subjects with angiographically normal coronary arteries, acetylcholine-induced coronary vasoconstriction correlated ...

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Section: Peripheral Arterial Disease (Pad)mentioning

confidence: 96%

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Shimabukuro

2009

Circ J

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“…Very few prospective studies have focused on the relation between triglycerides and peripheral vascular disease. The most common feature of PAD is raised levels of triglycerides and lower levels of high-density lipoprotein (HDL) cholesterol as compared with age-and sexmatched controls without vascular disease, with similar levels of cholesterol and low-density lipoprotein (LDL) cholesterol [43][44][45][46][47] . The frequency of a cluster of lipid abnormalities of the type of raised triglycerides and small and dense LDL and reduced HDL was 20% in persons with PAD vs 0% in the control group [48] .…”

Section: Fasting Lipids In Padmentioning

confidence: 99%

Peripheral arterial disease, type 2 diabetes and postprandial lipidaemia: Is there a link?

Valdivielso

Ramírez-Bollero

Pérez-López

2014

WJD

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“…Prospective studies have established tobacco consumption, diabetes, elevated blood pressure and cholesterol levels as the main predisposing factors to intermittent claudication (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(20)(21)(22). In most studies, tobacco consumption was the dominant risk factor.…”

Section: Discussionmentioning

confidence: 99%

Intermittent claudication: From its risk factors to its long-term prognosis in men. The Quebec Cardiovascular Study

St‐Pierre

Cantin

Lamarche

et al. 2010

Canadian Journal of Cardiology

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T he natural history of intermittent claudication (1-9) and lower limb arterial disease detected by abnormal ankle-brachial index (10-13), has been documented in longitudinal studies identifying the contributing risk factors as well as fatal cardiovascular disease (CVD) and allcause mortality outcomes. Although it is well known that patients with intermittent claudication are at high risk for cardiovascular death, the relationship with nonfatal CVD outcomes in a random population has been reported in only a few studies (8,(14)(15)(16). Likewise, little data have been published comparing the prognosis between persons with intermittent claudication and persons with other CVD (16,17). The present study was performed to further assess the long-term effects of risk factors on the development of intermittent claudication among 4376 men selected at random and without CVD at entry in 1974 and followed until 1998. In addition, to assess the prognosis of intermittent claudication, we computed the event rates between 1985 and 1998 among incident claudicants identified between 1974 and 1985; these claudicants without CVD were compared with men free of CVD and men with a first incident myocardial infarction (MI) without other CVD. Methods setting and populationThe population of the present study was previously described (18). In brief, from December 1973 to June 1974, 4637 men 35 to 64 years of age, representing 65% of a random sample of seven suburbs of Quebec City stratified according to age of men in the province of Quebec, answered a standardized medical questionnaire, and had their blood pressure measured and a blood sample taken for cholesterol determination. At entry, 245 men with CVD were excluded on the basis of a BACkGRound: The natural history of intermittent claudication, from its risk factors to its cardiovascular prognosis, has been reported in few prospective studies. oBJeCtIve: To assess incident intermittent claudication, as well as its risk factors and long-term prognosis in men. Methods: A random sample of 4376 men 35 to 64 years of age from Quebec City (Quebec), who were free of cardiovascular disease (CVD), was evaluated in 1974 for CVD risk factors and followed until 1998. To assess the prognosis, the event rates between 1985 and 1998 were computed among men with incident claudication without other CVD, incident survivors of a first myocardial infarction (MI) without other CVD and men free of CVD between 1974 and 1985. ResuLts: From 1974 to 1998, 300 men developed intermittent claudication. Tobacco consumption, high systolic blood pressure and diabetes at least doubled the adjusted RR (aRR) of intermittent claudication. In 1985, there were 80 claudicants, 2868 men free of CVD and 68 survivors of a first MI. During the 13-year follow-up, a new CVD occurred in 48.8% of the claudicants, in 18.9% of men without CVD (aRR 2.08; 95% CI 1.48 to 2.90) and in 45.6% of MI survivors (aRR compared with claudicants 1.12; 95% CI 0.69 to 1.79). There was also no significant difference between claudicants and MI survivo...

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Peripheral vascular disease: consequence for survival and association with risk factors in the Speedwell prospective heart disease study.

Cited by 129 publications

References 12 publications

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Peripheral arterial disease, type 2 diabetes and postprandial lipidaemia: Is there a link?

Intermittent claudication: From its risk factors to its long-term prognosis in men. The Quebec Cardiovascular Study

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