Abstract P306: Proportion of Community-dwelling Older Adults Potentially Benefiting From the Detection of Peripheral Arterial Disease (PAD) With Ankle-Brachial Index: the Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Background: The value of detecting PAD using the ankle-brachial index (ABI) among asymptomatic adults is controversial. However, the detection of PAD can help informing cardiovascular preventive therapy (e.g., statin and aspirin) and identifying PAD as a potential cause of reduced leg function which may be improved by exercise therapy. No previous studies have quantified the proportion of community-dwelling older adults who may benefit from PAD detection from these perspectives. Methods: In 4375 ARIC participants aged 66-90 between 2011-2013 without previously diagnosed PAD, we assessed the proportion of participants with newly detected PAD based on ABI who were not taking statin or aspirin and had reduced leg function (defined as the Short Physical Performance Battery score ≤9). Subsequently, we explored factors associated with higher odds of potentially benefitting from the detection of PAD (i.e., not taking statin/aspirin or having reduced leg function despite the presence of PAD) using logistic regression models. ABI ≤0.9 was the primary definition of PAD, but according to recent guidelines we secondarily explored ABI ≤1.0 or >1.4. Results: There were 236 (5.4%) participants with an ABI ≤0.9, among which 119 were not taking statin or aspirin and 151 had reduced leg function (77 having both conditions), leading to 193 (4.4%) participants potentially benefitting from PAD detection with ABI. The corresponding proportion was 12.4% (544) when abnormal ABI was defined as ≤1.0 or >1.4. Older age (per 10 years), black race, and current smoking were strongly associated with higher odds of potentially benefitting from detection of PAD (adjusted odds ratio >2.5). The proportion of benefitting from PAD detection was especially high in current smokers followed by blacks (proportions shown in Figure1). Conclusions: Up to 12.4% of community-dwelling older adults may benefit from PAD detection with ABI. The proportion are especially high among current smokers and black race, with implications on targeted ABI assessment for detecting PAD.