Impact of Peripheral Arterial Disease on Functional Limitation in Congestive Heart Failure: Results from the National Health and Nutrition Examination Survey (1999–2004)

Abstract

Background. Peripheral arterial disease (PAD) often coexists with congestive heart failure (CHF) and can be masked by symptoms of CHF such as functional limitation (FL), a common manifestation for both. Therefore, we sought to estimate the prevalence of PAD and its independent association with FL in CHF. Methods. We conducted a cross-sectional study on National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 to quantify weighted prevalence of CHF and PAD. Study cohort consisted of 7513, with ankle brachial index (ABI) measurements at baseline. Independent association of PAD (ABI ≤ 0.9) with FL in CHF was determined with multivariate logistic regression (MVLR). Results. Overall weighted PAD prevalence was 5.2%. CHF was present in 305 participants, and the weighted prevalence of PAD in this subgroup was 19.2%. When compared, participants with CHF and PAD were more likely to be older (P < 0.001), hypertensive (P = 0.005) and hypercholesterolemic (P = 0.013) than participants with CHF alone. MVLR showed that PAD (adjusted OR = 5.15; 95% CI: 2.2, 12.05: P < 0.05) and arthritis (adjusted OR = 2.36; 95% CI: 1.10, 5.06: P < 0.05) were independently associated with FL in CHF. Conclusion. Independent association of PAD with FL suggests the need for reinforced screening for PAD in individuals with CHF.

CHADS₂ Score and Risk of New-onset Peripheral Arterial Occlusive Disease in Patients without Atrial Fibrillation: A Nationwide Cohort Study in Taiwan

“…In addition, several studies have reported that the CHADS2 score can be used to predict subsequent cardiovascular events and new-onset AF in non-AF populations [11][12][13] . As an older age, hypertension, diabetes, congestive heart failure and stroke are all risk factors for PAOD [1][2][3][4][5][6][7] , our recent cross-sectional study demonstrated that the CHADS2 score is significantly associated with an ankle-brachial index (ABI) of 0.9 in non-AF patients 14) . However, divided the study patients into four groups: group 1 (score 0), group 2 (score 1-2), group 3 (score 3-4) and group 4 (score 5-6).…”

“…This condition shares similar risk factors with both coronary artery and cerebrovascular disease. Risk factors for PAOD include an advanced age, smoking, hypertension, diabetes, dyslipidemia, chronic kidney disease, congestive heart failure, stroke, race, obesity, elevated inflammatory markers and so on [1][2][3][4][5][6][7] . The CHADS2 score is a useful and well-known clinical score for assessing the risk of stroke in patients with AF 8,9) .…”

“…Major risk factors for PAOD include hypertension, diabetes mellitus, dyslipidemia, an advanced age and cigarette smoking 1,2) . In addition, chronic kidney disease, stroke, congestive heart failure, race, obesity and elevated inflammatory markers have also been reported to be associated with PAOD onset [1][2][3][4][5][6][7] . The CHADS2 score is a simple and reliable clinical score for assessing the risk of stroke in patients with atrial fibrillation (AF) 8,9) .…”

Lower Extremity Peripheral Artery Disease and Quality of Life Among Older Individuals in the Community

“…Peripheral arterial disease (PAD), commonly identified by an ankle‐brachial index (ABI) less than 0.9, is a growing problem 1. In the United States, PAD affects over 8 million individuals,2 with particularly high prevalence among people aged over 70 years 3, 4.…”

Lack of Benefits of Endurance Training in Patients with Chronic Heart Failure: Role of Asymptomatic Peripheral Artery Disease

“…The association of PAD with lower exercise capacity and lack of benefit to exercise training in HF subjects has been recently demonstrated in retrospective studies [6,7]. However most patients with PAD do not have classic intermittent claudication symptoms either because of their asymptomatic or because they have exertional leg symptoms other than intermittent claudication such as pain that does not cause the patient to stop walking or pain in different sites that not resolve early after rest [8].…”