Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the Multi-Ethnic Study of Atherosclerosis (MESA). Aboyans, V., Criqui, M. H., McClelland, R. L., Allison, M. A., Tian, L., McDermott, M. M., Goff, D. C., David C. Goff, David C. Goff, David C. Goff, & Manolio, T. A. Journal of Vascular Surgery, 45(2):319–327, February, 2007. MAG ID: 1969851336
doi  abstract   bibtex   
Objective Several studies report a higher prevalence of peripheral arterial disease (PAD) in women and among blacks. These studies based their PAD definition on an ankle-brachial index (ABI) Methods A cross-sectional study was designed as part of the Multi-Ethnic Study of Atherosclerosis (MESA), a multicenter United States population study. We selected a subgroup of participants with unequivocally normal ABIs (1.00 to 1.30), and additionally excluded participants with any major PAD risk factor (smoking, diabetes, dyslipidemia, hypertension). In a linear model with ABI as the dependent variable, demographic, clinical, biologic, and social variables were introduced as independent factors. Results Among 1775 healthy participants, there was no association between ABI level and subclinical cardiovascular disease (coronary calcium or carotid plaque). Male gender, weight, and high education level were positively correlated with ABI, whereas black race, triglycerides, pack-years (in past smokers), and pulse pressure were negatively correlated. In the fully adjusted model, women had about 0.02 lower ABI values than men, and blacks showed ABI values about 0.02 lower than non-Hispanic whites. Conclusion These data suggest intrinsic ethnic and gender differences in ABI. Such differences, although small in magnitude, are highly significant and can distort population estimates of disease burden.
@article{aboyans_intrinsic_2007,
	title = {Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the {Multi}-{Ethnic} {Study} of {Atherosclerosis} ({MESA}).},
	volume = {45},
	doi = {10.1016/j.jvs.2006.10.032},
	abstract = {Objective  Several studies report a higher prevalence of peripheral arterial disease (PAD) in women and among blacks. These studies based their PAD definition on an ankle-brachial index (ABI)   Methods  A cross-sectional study was designed as part of the Multi-Ethnic Study of Atherosclerosis (MESA), a multicenter United States population study. We selected a subgroup of participants with unequivocally normal ABIs (1.00 to 1.30), and additionally excluded participants with any major PAD risk factor (smoking, diabetes, dyslipidemia, hypertension). In a linear model with ABI as the dependent variable, demographic, clinical, biologic, and social variables were introduced as independent factors.  Results  Among 1775 healthy participants, there was no association between ABI level and subclinical cardiovascular disease (coronary calcium or carotid plaque). Male gender, weight, and high education level were positively correlated with ABI, whereas black race, triglycerides, pack-years (in past smokers), and pulse pressure were negatively correlated. In the fully adjusted model, women had about 0.02 lower ABI values than men, and blacks showed ABI values about 0.02 lower than non-Hispanic whites.  Conclusion  These data suggest intrinsic ethnic and gender differences in ABI. Such differences, although small in magnitude, are highly significant and can distort population estimates of disease burden.},
	number = {2},
	journal = {Journal of Vascular Surgery},
	author = {Aboyans, Victor and Criqui, Michael H. and McClelland, Robyn L. and Allison, Matthew A. and Tian, Lu and McDermott, Mary M. and Goff, David C. and {David C. Goff} and {David C. Goff} and {David C. Goff} and Manolio, Teri A.},
	month = feb,
	year = {2007},
	doi = {10.1016/j.jvs.2006.10.032},
	pmid = {17264011},
	note = {MAG ID: 1969851336},
	pages = {319--327},
}

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