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Variation in cardiovascular risk factors by angiographic site of lower limb atherosclerosis
F B Smith1, A J Lee, F G Fowkes
1Wolfson Unit for Prevention of Peripheral Vascular Diseases, Department of Public Health Sciences, University of Edinburgh, UK.
Insights
Cardiovascular risk factors like smoking and high cholesterol differ based on lower limb atherosclerosis site. Aortoiliac disease is linked to younger females and higher diastolic pressure, while femoropopliteal disease shows higher cholesterol.
Area of Science:
- Vascular Medicine
- Cardiovascular Epidemiology
- Atherosclerosis Research
Background:
- Lower limb atherosclerosis manifests at various arterial sites.
- Cardiovascular risk factors are implicated in atherosclerosis development.
- Understanding site-specific risk factor profiles is crucial for targeted prevention.
Purpose of the Study:
- To investigate differences in cardiovascular risk factors among patients with distinct lower limb atherosclerosis locations.
- To identify potential associations between specific risk factors and the anatomical distribution of atherosclerosis.
Main Methods:
- A cross-sectional survey of 192 patients with intermittent claudication or rest pain.
- Patients were categorized by atherosclerosis site (aortoiliac, femoropopliteal, dual-site) using the Bollinger scoring system.
- Assessment included smoking history, serum lipids (total cholesterol, HDL cholesterol), cotinine, thiocyanate, blood pressure, and ankle-brachial pressure index (ABPI).
Main Results:
- Aortoiliac disease patients were younger, more likely female and current smokers, with higher diastolic blood pressure.
- Femoropopliteal disease patients exhibited higher lifetime cigarette consumption and total cholesterol levels.
- Dual-site disease was associated with a higher prevalence of myocardial infarction and angina pectoris, and higher systolic blood pressure.
Conclusions:
- Distinct patterns of cardiovascular risk factors correlate with specific sites of lower limb atherosclerosis.
- These findings suggest that different risk factor profiles may predispose individuals to atherosclerosis at different anatomical locations.
- Further large-scale population studies are needed to precisely define these site-specific risks.
Objective:
To determine differences in the levels of the cardiovascular risk factors, cigarette smoking, serum lipids and blood pressure, between three groups of patients with different sites of lower limb atherosclerosis.
Design:
Cross-sectional survey of a consecutive series of patients with symptoms of either intermittent claudication or rest pain.
Methods And Materials:
One hundred and ninety-two men and women who had undergone angiography were classified using the Bollinger scoring system into groups with predominantly aortoiliac, femoropopliteal or dual-site disease. History of cigarette smoking, serum cotinine, serum thiocyanate, total cholesterol and HDL cholesterol were estimated. Systolic and diastolic pressures were measured and the ankle brachial pressure index (ABPI) was calculated.
Results:
Eighty-five patients were classified as having femoropopliteal disease, 34 aortoiliac disease and 73 dual-site disease. After adjusting for age, sex and severity of disease, aortoiliac patients were significantly younger (p
Conclusion:
different levels of cardiovascular risk factors may predispose individuals to atherosclerosis at different sites in the lower limb. Large population studies would be required to delineate the risks more precisely.