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Ankle brachial index (ABI) in a cohort of older women in the Philippines: Prevalence of peripheral artery disease and predictors of ABI
Author(s) -
Kuzawa Christopher W.,
Barrett Tyler M.,
Borja Judith B.,
Lee Nanette R.,
Aquino Celine T.,
Adair Linda S.,
McDade Thomas W.
Publication year - 2019
Publication title -
american journal of human biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.559
H-Index - 81
eISSN - 1520-6300
pISSN - 1042-0533
DOI - 10.1002/ajhb.23237
Subject(s) - medicine , body mass index , epidemiology , arterial disease , disease , ankle , cohort , demography , cohort study , physical therapy , vascular disease , surgery , sociology
Objective Cardiovascular disease (CVD) is rising in low and middle‐income countries, but studies of CVD epidemiology in such settings often focus on risk factors rather than measures of disease progression. Here we use the ankle brachial index (ABI) to assess the prevalence of peripheral artery disease (PAD) among older women living in Metropolitan Cebu, Philippines, and relationships between ABI and CVD risk factors and body composition. Methods ABI was measured using the Doppler technique in 538 female participants in the 2015 Cebu Longitudinal Health and Nutrition Survey (mean age 58 years, range 47‐78 years). ABI was related to a panel of CVD risk factors measured in 2005 and 2012, and to 2012 body composition measures. Results The prevalence of PAD (1.8%) was among the lowest reported in any comparably‐aged sample, and only 9.9% of participants had an ABI indicating borderline PAD risk. Smoking ( P < 0.011) and use of CVD medications ( P < 0.0001) predicted lower ABI (indicating higher PAD risk), which was also lower in relation to 2012 systolic blood pressure ( P < 0.054). ABI was unrelated to other CVD risk factors. An apparent protective relationship between body mass index (BMI) and ABI, noted in previous studies, was found to be confounded by protective relationships between ABI and fat free mass, height, and grip strength (all P < 0.05). Conclusions The prevalence of PAD is low in Cebu Longitudinal Health and Nutrition Survey participants, and ABI was related to few CVD risk factors. Past reports of lower PAD risk in relation to BMI may reflect confounding by lean mass, which has protective relationships with ABI.