Prevalence and Correlates of Symptomatic Peripheral Atherosclerosis in Individuals with Coronary Heart Disease and Cholesterol Levels Less Than 240 mg/dL: Baseline Results from the Cholesterol And Recurrent Events (CARE) Study

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Abstract
Purpose: To determine the prevalence and correlates of symptomatic peripheral athero sclerosis in individuals with a history of myocardial infarction (MI) and cholesterol levels lower than 240 mg/dL. Materials and Methods: A cross-sectional analysis was conducted at baseline of 4159 participants in the Cholesterol and Recurrent Events (CARE) Study. Symptomatic diffuse atherosclerosis was defined as a history of MI plus lower extremity or cerebrovascular atherosclerosis or claudication by Rose questionnaire. Results: The prevalence of symptomatic diffuse atherosclerosis was 12.9%; 353 partici pants (8.5%) had lower extremity disease and 219 (5.3%) had cerebrovascular disease. After controlling for other variables, diffuse atherosclerosis was associated with age (Odds Ratio [OR] = 1.44 per ten-year increase), systolic blood pressure (OR=1.13 per 10 mm Hg increase), a history of multiple myocardial infarctions (OR= 1.76), diabetes (OR=1.76), hypertension (OR=1.38), reduced exercise performance (OR=1.55), current smoking status (OR=2.87), and lower alcohol intake (OR=0.97 per drink per week). There was no association with race, gender, or lipid levels. Conclusions: The presence of clinically evident diffuse atherosclerosis is common and is associated with several modifiable risk factors. Early identification of these individuals could affect treatment and clinical outcomes.