| Summary: | Background: We investigate whether peripheral arterial disease (PAD) detected by ankle brachial index (ABI) <0.9 is independently associated with aortic stiffness and lipoprotein (a) [Lp(a)] in elderly subjects free from PAD at baseline.
Methods: The present study included 96 lecture attendees (“Continuing Adult Education”) who were examined at baseline and after a median follow-up of 9.5 years. We used multiple linear and logistic regression analyses to assess predictors of ABI change. As independent covariates we considered parameters with known effect on arterial stiffness or ABI and use of antihypertensive medication.
Results: At baseline, mean age was 67.2±4.9 years, 79.2% were women, 33.3% of subjects had arterial hypertension and 5.2% diabetes mellitus, respectively. During the follow-up, the ABI decreased (1.15±0.12 vs. 1.00±0.19; P<0.0001) and there were 27 incident cases of PAD. While accounting for covariates, change in ABI was associated with Lp(a) (β = 0.045±0.018; P=0.017) and PWV (β=–0.038±0.017; P=0.025). Additional adjustment for antihypertensive treatment weakened the association between PWV and change in ABI (P=0.091). The incidence of PAD was associated only with Lp(a) (OR 0.55, 95%CI 0.32 – 0.97; P=0.038). PWV was not significant predictor of incident PAD neither in basic adjusted model nor in model adjusted also for antihypertensive treatment (P≥0.18).
Conclusions: In elderly subjects without manifest PAD at baseline are lipoprotein (a) and aortic stiffness associated with change in ABI and incidence of peripheral arterial disease, however antihypertensive treatment started during follow-up modifies these observations.
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