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26-09-2011 | Cardiometabolic | Article

Healthy weight, not smoking reduces PAD risk in older adults


Free abstract

MedWire News: Maintaining a healthy weight and not smoking may decrease a person's risk for developing peripheral artery disease (PAD), study results suggest.

The findings, published in the American Journal of Epidemiology, showed a positive association between body mass index (BMI) and PAD prevalence and incidence among older individuals (over 65 years) who had a good health status and had never smoked.

In addition, individuals who had prevalent PAD were less likely to have gained weight since age 50 years and were more likely to report unintentional weight loss.

"Collectively, these findings demonstrate that smoking, poor health status, weight loss, and PAD often coexist in older persons and complicate the evaluation of associations of BMI with PAD," say Joachim Ix (University of California, San Diego, USA) and team.

The authors explain that, although most traditional and novel cardiovascular disease (CVD) risk factors are strongly associated with PAD, BMI is an "important exception." Indeed, many studies have found either no association or an inverse association between BMI and PAD prevalence.

The researchers hypothesized that smoking and poor health status might simultaneously be associated with lower BMI and greater PAD prevalence, thereby obscuring any positive association that might exist if adiposity is directly or indirectly involved in the development of PAD.

To test this hypothesis, the team conducted an observational study among 5419 participants of the Cardiovascular Health Study who were aged over 65 years at baseline. Of these, 19% were obese (BMI ≥30 kg/m2).

The researchers report that during a median 13.2 years of follow-up, 276 incident PAD events occurred.

In line with previous findings, cross-sectional analysis revealed that each 5-unit increase in BMI was associated with an 8% reduction in the prevalence of PAD, when all participants were included.

However, among persons who had never smoked and reported good, very good, or excellent health, and who did not report unintentional weight loss in the year preceding the baseline visit, the direction of association was reversed; each 5-unit increase in BMI was associated with a 20% increased prevalence of PAD.

Similar results were observed between BMI calculated using an individual's weight at 50 years of age, and between BMI at baseline and incident PAD events, with respective prevalence and hazard ratios of 1.30 and 1.32.

"If our findings are confirmed, preventive strategies focused on maintenance of normal weight may decrease PAD incidence and associated comorbidity in later life," conclude the authors.

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By Nikki Withers