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Prevalence of low ankle-brachial index, elevated plasma fibrinogen and CRP across Framingham risk categories: data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004.

Publication ,  Journal Article
Dhangana, R; Murphy, TP; Pencina, MJ; Zafar, AM
Published in: Atherosclerosis
May 2011

OBJECTIVE: 60-80% of heart attacks or coronary-related deaths occur in individuals identified as non-high-risk per the conventional risk assessment algorithms. Abnormal ankle-brachial index (ABI), plasma fibrinogen and plasma C-reactive protein (CRP) have been shown to be associated with a higher risk of cardiovascular disease (CVD). However, comparable data have not been reported for prevalence of abnormal ABI, fibrinogen and CRP in non-high-risk population. METHODS: We analyzed data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of the U.S. population, for 6292 men and women, aged 40 and older, without known CVD or diabetes, with available data on standard CVD risk factors, ABI, fibrinogen and CRP. The main objective was to identify proportions of individuals with abnormal ABI (ABI<0.9 in either leg), elevated fibrinogen (≥ 400 mg/dl), and elevated CRP (>3mg/l), with otherwise low or intermediate (<20%) 10-year Framingham risk score. RESULTS: Overall prevalence of abnormal ABI, fibrinogen, and CRP was 3.6% (95% CI 3.2-4.1%), 27.4% (95% CI 23.9-31.0%) and 38.3% (95% CI 36.5-40.0%) respectively. Among those with ABI data, 91.4% were at <20% FRS, and of these only 2.7% (95% CI 2.3-3.1%, p < 0.0001) had an abnormal ABI. Among those with fibrinogen data, 90.8% were at <20% FRS, and of these 23.6% (95% CI 20.4-26.8%, p < 0.001) had elevated plasma fibrinogen. Among those with CRP data, 91.1% were at <20% FRS, and of these 34.3% (95% CI 32.7-36.0%, p = 0.0012) had an elevated CRP. Overall, 45.0% (95% CI 42.2-47.8%; p < 0.0001) had abnormal ABI, fibrinogen or CRP but low-intermediate risk. CONCLUSION: Abnormal ABI, elevate fibrinogen and CRP are highly prevalent among individuals otherwise at low-intermediate risk. If any or all of them are shown to improve predictive ability of FRS for primary prevention, it would have a significant public health impact.

Duke Scholars

Published In

Atherosclerosis

DOI

EISSN

1879-1484

Publication Date

May 2011

Volume

216

Issue

1

Start / End Page

174 / 179

Location

Ireland

Related Subject Headings

  • Up-Regulation
  • United States
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Prevalence
  • Peripheral Vascular Diseases
  • Nutrition Surveys
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dhangana, R., Murphy, T. P., Pencina, M. J., & Zafar, A. M. (2011). Prevalence of low ankle-brachial index, elevated plasma fibrinogen and CRP across Framingham risk categories: data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Atherosclerosis, 216(1), 174–179. https://doi.org/10.1016/j.atherosclerosis.2010.10.021
Dhangana, Rajoo, Timothy P. Murphy, Michael J. Pencina, and Abdul M. Zafar. “Prevalence of low ankle-brachial index, elevated plasma fibrinogen and CRP across Framingham risk categories: data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004.Atherosclerosis 216, no. 1 (May 2011): 174–79. https://doi.org/10.1016/j.atherosclerosis.2010.10.021.
Dhangana, Rajoo, et al. “Prevalence of low ankle-brachial index, elevated plasma fibrinogen and CRP across Framingham risk categories: data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004.Atherosclerosis, vol. 216, no. 1, May 2011, pp. 174–79. Pubmed, doi:10.1016/j.atherosclerosis.2010.10.021.
Journal cover image

Published In

Atherosclerosis

DOI

EISSN

1879-1484

Publication Date

May 2011

Volume

216

Issue

1

Start / End Page

174 / 179

Location

Ireland

Related Subject Headings

  • Up-Regulation
  • United States
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Prevalence
  • Peripheral Vascular Diseases
  • Nutrition Surveys
  • Middle Aged
  • Male