Abstract 3430: Ethnic Differences in the Prevalence and Treatment of Cardiovascular Risk Factors in Outpatients with Peripheral Arterial Disease: Insights from the REACH Registry

Abstract

Background : In the United States, African Americans have been reported to have an increased prevalence of peripheral arterial disease (PAD) with poorer outcomes as compared to whites. Whether this can be attributed to differences in the presence and treatment of traditional coronary artery disease (CAD) risk factors versus other factors specifically related to ethnicity is unknown. Methods : We identified 2,235 patients from the United States with documented PAD with and without concomitant CAD and cerebrovascular disease (CVD) at one year enrolled in the REduction of Atherothrombosis for Continued Health (REACH) Registry. We compared the baseline demographics, risk factor profiles, medication use, and one-year outcomes between the 236 African Americans and 1,810 non-Hispanic whites. Results : Among the traditional atherosclerotic risk factors, African Americans were more likely than whites to have diabetes (64.0% vs. 48.6%, p<0.0001), hypertension (95.3% vs. 86.5%, p=0.0001), obesity (45.9% vs. 34.3%, p=0.0002), and isolated PAD (44.9% vs. 28.7%, p<0.0001). In comparison to whites, African Americans were less likely to be on aspirin (62.0% vs. 72.4%, p=0.0009) and lipid-lowering therapy (76.1% vs. 83.2%, p=0.0071), and more likely to have an elevated blood pressure (BP ≥140/90 mmHg: 54.9% vs. 38.1%, p<0.0001) and fasting cholesterol (>200 mg/dL: 41.7% vs. 24.9%, p<0.0001) at baseline. Overall, there were no significant difference in all-cause mortality (4.70% vs. 5.32%, p=0.97) or CV death, MI, or stroke (4.92% vs. 6.20%, p=0.79) between African Americans and whites in this cohort (data adjusted for age and sex). Conclusion : Among U.S. outpatients with PAD, African Americans are more likely than whites to have risk factors for cardiovascular disease, but less likely to receive aspirin or lipid-lowering therapy. In this registry, one-year event rates are relatively high, but similar in both groups.