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Subclavian artery stenosis: prevalence, risk factors, and association with cardiovascular diseases

Ramin Shadman1, Michael H Criqui, Warner P Bundens

  • 1University of California-San Diego, School of Medicine, San Diego, California 92093-0607, USA.

Journal of the American College of Cardiology
|September 11, 2004
PubMed

Insights

Subclavian artery stenosis (SS) affects about 2% of the general population and 7% of clinical patients. Risk factors include smoking and high blood pressure, and it

Area of Science:

  • Cardiovascular medicine
  • Vascular disease epidemiology
  • Diagnostic screening

Background:

  • The prevalence of subclavian artery stenosis (SS) in the general population remains largely unknown.
  • Established risk factors and associations with other cardiovascular diseases for SS are not well-defined.

Purpose of the Study:

  • To determine the prevalence of subclavian artery stenosis (SS) in both free-living and clinical populations.
  • To identify risk factors associated with SS.
  • To investigate the relationship between SS and other cardiovascular conditions.

Main Methods:

  • A cross-sectional analysis of 4,223 subjects from two free-living and two clinical cohorts.
  • Subclavian artery stenosis (SS) was defined by an interarm blood pressure difference of >= 15 mm Hg.

Main Results:

  • Prevalence of SS was 1.9% in free-living cohorts and 7.1% in clinical cohorts.
  • SS was significantly associated with past smoking (OR=1.80), current smoking (OR=2.61), and higher systolic blood pressure (OR=1.90 per 20 mm Hg).
  • Higher HDL cholesterol levels showed an inverse association with SS (OR=0.87 per 10 mg/dl).
  • SS was significantly associated with peripheral arterial disease (PAD) (OR=5.11).

Conclusions:

  • Subclavian artery stenosis (SS) is present in approximately 2% of the general population and 7% of clinical patients.
  • SS is linked to smoking history, elevated systolic blood pressure, lower HDL cholesterol, and PAD.
  • Routine bilateral brachial blood pressure measurements are recommended for high-risk individuals to screen for SS and avoid misdiagnosis of hypertension or PAD.
Abstract

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