Faculty Collaboration Database

Association of sex and height with a lower ankle brachial index in the general population. Vasc Med 2018 Dec;23(6):534-540

Date

06/06/2018

Pubmed ID

29865989

Pubmed Central ID

PMC9552311

DOI

10.1177/1358863X18774845

Scopus ID

2-s2.0-85048110823 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

The ankle-brachial index (ABI) is a predictor of cardiovascular events, mortality and functional status. Some studies have noted a higher prevalence of peripheral artery disease in females compared to males. Differences in height might account for these observed sex differences, but findings are conflicting. The 2003-2004 National Health and Nutrition Examination Survey (NHANES) cohort includes participants from 15 geographic locations, selected annually to represent the general population. Sample-weighted multivariable linear and logistic regression modeling was performed with ABI as the dependent variable and height and sex as primary exposure variables of interest. There were 3052 participants with ABI data (mean age 57 years, 51% female). The mean (±SE) ABI was 1.09 (±0.006) and 1.13 (±0.005) for females and males, respectively ( p < 0.0001). Shorter height was associated with a low ABI (OR 0.91 per 4 cm, 95% CI: 0.86-0.96; p=0.001). In a fully adjusted model, female sex was associated with a low ABI (OR 1.34, 95% CI: 1.04-1.72; p=0.025) independent of height and traditional cardiovascular disease (CVD) risk factors. Age, diabetes, tobacco use, known CVD, hypertension and race were associated with a low ABI (all p < 0.001). The ABI was 0.03 lower in females than in males in the general population and in a healthy cohort. Lower ABI values in healthy females do not appear to be due to occult vascular disease but rather a normal phenomenon with some contribution from height. Therefore, population sex-specific ABI thresholds should be utilized in the diagnosis of peripheral artery disease to account for these intrinsic differences.

Author List

Kapoor R, Ayers C, Visotcky A, Mason P, Kulinski J

Authors

Jacquelyn P. Kulinski MD Associate Professor in the Medicine department at Medical College of Wisconsin
Peter Mason MD Professor in the Medicine department at Medical College of Wisconsin
Alexis M. Visotcky Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Ankle Brachial Index
Body Height
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Nutrition Surveys
Peripheral Arterial Disease
Predictive Value of Tests
Prevalence
Risk Assessment
Risk Factors
Sex Factors
United States