Gender and ethnic differences in arterial compliance in patients with intermittent claudication

• Published in: Journal of vascular surgery Vol. 51; no. 3; pp. 610 - 615
• Main Authors: Gardner, Andrew W., PhD, Montgomery, Polly S., MS, Blevins, Steve M., MD, Parker, Donald E., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-03-2010; Elsevier
• Subjects: African Americans - statistics & numerical data; Aged; Aged, 80 and over; Ankle - blood supply; Arteries - physiopathology; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; Brachial Artery - physiopathology; Compliance; Cross-Sectional Studies; European Continental Ancestry Group - statistics & numerical data; Female; General and cellular metabolism. Vitamins; Health Status Disparities; Humans; Hypoglycemic Agents - therapeutic use; Intermittent Claudication - blood; Intermittent Claudication - ethnology; Intermittent Claudication - physiopathology; Lipids - blood; Male; Medical sciences; Metabolic Syndrome - ethnology; Metabolic Syndrome - physiopathology; Microcirculation; Middle Aged; Obesity, Abdominal - ethnology; Obesity, Abdominal - physiopathology; Pharmacology. Drug treatments; Sex Factors; Smoking - ethnology; Smoking - physiopathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Human; Claudication; Cardiovascular disease; Intermittent; Surgery
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2009.09.059

Objective To assess the gender and ethnic differences in arterial compliance in patients with intermittent claudication. Methods A total of 114 patients participated, including 38 Caucasian men, 32 Caucasian women, 16 African American men, and 28 African American women. Patients were assessed on large artery elasticity index (LAEI), small artery elasticity index (SAEI), age, weight, body mass index, ankle-brachial index (ABI), smoking status, and metabolic syndrome components. Results Group differences were found for LAEI ( P = .042), SAEI ( P = .019), body mass index ( P = .020), prevalence of elevated fasting glucose ( P = .001), and prevalence of abdominal obesity ( P = .025). Significant covariates for LAEI included age ( P = .0002) and elevated triglycerides ( P = .0719). LAEI (units = 10 mL × mm Hg) adjusted for age and triglycerides was 39% lower ( P = .0005) in African Americans (11.4 ± .90; mean ± SE) than in Caucasians (15.8 ± 0.72), whereas no significant difference ( P = .7904) existed between men (13.8 ± 0.81) and women (13.5 ± 0.79). Significant covariates for SAEI included age ( P = .0001), abdominal obesity ( P = .0030), and elevated blood pressure ( P = .0067). SAEI (units = 100 mL × mm Hg) adjusted for age, abdominal obesity, and elevated blood pressure was 32% lower ( P = .0007) in African-Americans (2.8 ± 0.3) than in Caucasians 4.1 ± 0.2), and was 18% lower ( P = .0442) in women (3.1 ± 0.2) than in men (3.8 ± 0.2). Conclusion African American patients with intermittent claudication have more impaired macrovascular and microvascular function than Caucasian patients, and women have more impaired microvascular function than men. These ethnic and gender differences in arterial compliance are evident even though ABI was similar among groups, suggesting that arterial compliance provides unique information to quantify vascular impairment in patients with intermittent claudication.