Carotid and lower extremity arterial disease in elderly adults with isolated systolic hypertension.

The prevalence of carotid and lower extremity arterial disease was assessed in a healthy population of 56 elderly adults with isolated systolic hypertension. Duplex scans were performed to determine the extent of carotid disease, and postexercise ratios of ankle to arm systolic blood pressure were measured to assess lower extremity arterial disease. Internal carotid stenosis was found in 38% (21 of 56) of subjects and lower extremity arterial disease in 42% (23 of 55). The strongest predictor of internal carotid stenosis was lower extremity arterial disease. Independent risk factors for lower extremity arterial disease were smoking, internal carotid stenosis, and age. A measure of extent of carotid plaque was found to correlate with age, carotid stenosis, male sex, history of smoking, and total cholesterol. The high prevalence of peripheral vascular disease in this population may be related to their age and blood pressure. The high correlation between carotid stenosis and lower extremity arterial disease suggests that persons with peripheral vascular disease should be assessed and treated for atherosclerotic disease in general.