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Prevalence and Correlates of Symptomatic Peripheral Atherosclerosis in Individuals with Coronary Heart Disease and Cholesterol Levels Less Than 240 mg/dL: Baseline Results from the Cholesterol And Recurrent Events (CARE) Study

Section of General Internal Medicine, Minneapolis VA Medical Center, Minneapolis, MN

Barry R. Davis

University of Texas School of Public Health, Houston, TX

David G. Meyers

Division of Cardiovascular Medicine and Department of Preventive Medicine, Kansas University Medical Center, Kansas City, KS

Jean-Lucien Rouleau

Department of Cardiology, Montreal Heart Institute, Montreal, Quebec, Canada

Frank M. Sacks

Channing Laboratory and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts

Purpose: To determine the prevalence and correlates of symptomatic peripheral athero sclerosis in individuals with a history of myocardial infarction (MI) and cholesterol levels lower than 240 mg/dL.

Materials and Methods: A cross-sectional analysis was conducted at baseline of 4159 participants in the Cholesterol and Recurrent Events (CARE) Study. Symptomatic diffuse atherosclerosis was defined as a history of MI plus lower extremity or cerebrovascular atherosclerosis or claudication by Rose questionnaire.

Results: The prevalence of symptomatic diffuse atherosclerosis was 12.9%; 353 partici pants (8.5%) had lower extremity disease and 219 (5.3%) had cerebrovascular disease. After controlling for other variables, diffuse atherosclerosis was associated with age (Odds Ratio [OR] = 1.44 per ten-year increase), systolic blood pressure (OR=1.13 per 10 mm Hg increase), a history of multiple myocardial infarctions (OR= 1.76), diabetes (OR=1.76), hypertension (OR=1.38), reduced exercise performance (OR=1.55), current smoking status (OR=2.87), and lower alcohol intake (OR=0.97 per drink per week). There was no association with race, gender, or lipid levels.

Conclusions: The presence of clinically evident diffuse atherosclerosis is common and is associated with several modifiable risk factors. Early identification of these individuals could affect treatment and clinical outcomes.

Angiology, Vol. 47, No. 6, 533-541 (1996)
DOI: 10.1177/000331979604700601


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