Arterial leg disease may be more common in blacks

December 20, 2005

African-Americans are more likely to have problems with circulation in their legs due to hardening of the arteries, or atherosclerosis, according to a national study of more than 15,000 adults.

Arterial leg disease was diagnosed in 4.4 percent in African-American women, 3.1 percent of African-American men, 3.2 percent of white women and 2.3 percent of white men in the study in the latest issue of American Journal of Preventive Medicine.

The researchers, led by Zhi-Jie Zheng, M.D, also found that cigarette smoking was the single most important risk factor for arterial leg disease.

Advanced cases of arterial leg disease can lead to amputation of the foot or leg, according to Zheng, an epidemiologist at the Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention.

In the study, arterial leg disease was diagnosed by measuring resting blood pressure in the ankle and the arm, and determining the ratio between them, called the resting ankle-brachial index. The condition was diagnosed when the ratio was less than or equal to 0.9.

The condition was associated with hypertension, diabetes, and higher concentrations of total cholesterol, triglycerides, LDL cholesterol and lower concentrations of HDL (good) cholesterol.

The higher rate of arterial leg disease in African-Americans may be due to the higher prevalence of diabetes and hypertension in this population, according to the researchers.

The same risk factors for other cardiovascular diseases -- such as smoking, high blood pressure, diabetes, and high cholesterol levels -- are associated with arterial leg disease regardless of age, gender or racial and ethnic background. The presence of arterial leg disease may predict other cardiovascular problems.

People with early arterial disease may not have any symptoms. But if not treated properly, arterial leg disease can lead to pain or cramping in the legs, especially during exercise.

Because the condition is associated with other atherosclerotic problems, an ankle-brachial index of 0.9 or less may be predictive of heart disease and stroke. "Thus, a simple measure of ankle blood pressure is an excellent screening test for systemic atherosclerotic disease," Zheng said.
All people in the study had participated in a baseline examination between 1987 and 1989, as part of the larger Atherosclerosis Risk in Communities Study sponsored by the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Zhi-Jie Zheng at
American Journal of Preventive Medicine: Contact the editorial office at (858) 457-7292.

Zheng, Z-J, et al. Lower extremity arterial disease assessed by brachial index in a middle-aged population of African Americans and whites: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Prev Med 29(4,supp), 2005.

Center for Advancing Health

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