Family History of Peripheral Artery Disease Is Associated With Prevalence and Severity of Peripheral Artery Disease: The San Diego Population Study

Sep 12, 2011
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Authors:
Wassel CL, Loomba R, Ix JH, Allison MA, Denenberg JO, Criqui MH.
Citation:
J Am Coll Cardiol 2011;58:1386-1392.
Summary By:
James B. Froehlich, MD, MPH, FACC

Study Questions:

Is a family history of peripheral artery disease (PAD) associated with the population prevalence of PAD?

Methods:

The authors reported an analysis of data from the San Diego Population Study, which enrolled an ethnically diverse group of men and women who were current or former employees of the University of California, San Diego, between 1994 and 1998, and assessed them for prevalent PAD. Family history of PAD was defined as any first-degree relative with PAD, and PAD was defined as ankle brachial index <0.90, or any previous leg revascularization. Association of family history of PAD with prevalent PAD was assessed with logistic regression. Covariates included age, sex, race or ethnicity, diabetes, cigarette smoking, hypertension, and body mass index.

Results:

Among 2,404 subjects, the mean age was 59 (standard deviation, 11 years), 66% were women, and 58% were Caucasian. Prevalence of PAD was 3.6%, with 1.9% having severe PAD (ankle-brachial index <0.7). After adjusting for multiple variables, family history of PAD was strongly associated with PAD (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.03-3.26; p = 0.04), and even more so with severe PAD (OR, 2.42; 95% 1.13 to 5.23; p = 0.02).

Conclusions:

The authors concluded that a family history of PAD is independently strongly associated with PAD prevalence and severity. They further opined that this indicates a role for genetic factors or other shared environmental factors, or both, contributing to PAD.

Perspective:

The current population-based study provides good evidence that there likely is a genetic—or strongly environmental—etiology for PAD. If nothing else, this confirms the validity of using family history as a risk factor for predicting PAD. Furthermore, it should encourage the continued search for genetic factors that play a role in PAD pathogenesis. Identification of such factors may yet yield the hoped-for novel insights into etiology that permit therapeutic interdiction.

Keywords: Prevalence, Peripheral Arterial Disease


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