Segmental arterial disease in the lower extremities: correlates of disease and relationship to mortality

The purpose of this study was to identify the correlates of disease and mortality risk associated with the presence of stenosis in the major arterial segments of the lower limb in men and women evaluated in a peripheral vascular laboratory. A total of 326 men and 249 women had unisegmental stenosis; 312 men and 275 women had multisegmental disease; 132 men and 111 women had no apparent disease. Multivariate analysis indicated that current smoking and elevated systolic blood pressure were the key risk factors associated with isolated aortoiliac and femoropopliteal arterial disease in both men and women. A history of diabetes was significantly associated with tibioperoneal disease in men while elevated systolic blood pressure was the major correlate of distal disease in women in this patient population. The relative risk of mortality was elevated 2- to 7-fold in men and women with multi- and unisegmental disease involving the aortoiliac and femoropopliteal segments; presence of tibioperoneal disease did not significantly increase mortality relative to those who were free of disease. These results suggest that the etiology and mortality risk associated with atherosclerosis in the lower extremity may vary with the anatomic site and/or severity of the lesion.