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Peripheral Atherosclerotic Disease: Aging and Risk Factors

The aim of this study was to assess the prevalence of peripheral atherosclerotic disease (PAD) and its relation to principal cardiovascular risk factors, at different ages, in a sample of the general population. Ultrasonographic methods (continuous wave Doppler and high-resolution B-mode Doppler) were used to evaluate the ankle-to-arm ratio and to investigate the femoral district in 457 free-living subjects (231 men and 226 women, mean age 55.4 ±18.7 years) resident in the metropolitan area of Turin. PAD, detected by ankle-to-arm ratio, was observed in 148 subjects (32.4%). Femoral plaques were found in 180 subjects (39.4%). The overall prevalence of atherosclerosis, number of plaques, and percentage of stenosis were observed to increase with age (P < 0.0001). In the multiple logistic regression model, analysis of subjects under sixty-five years of age showed independent associations between femoral atherosclerosis and age (P < 0.0001), LDL cholesterol (P < 0.01), cigarette smoking (P < 0.05), and years of exposure to smoking (P < 0.05); analysis of subjects over sixty-five years of age showed positive and independent associations only with age (P < 0.001), male gender (P < 0.01), and cigarette smoking (P < 0.05). The authors conclude that there is a high prevalence of asymptomatic lower limb atherosclerosis in the general population, particularly among the very old. The association between risk factors and femoral atherosclerosis is less pronounced in the elderly than in younger subjects.