Maintaining an optimal body mass index (BMI), in addition to controlling other cardiovascular risk factors, may reduce the risk of peripheral artery disease (PAD) with critical limb ischemia (CLI), according to new research in the Journal of the American Heart Association.
Previous studies have found that smoking, hypertension and diabetes are “major risk factors” for clinically significant PAD, but there is a paucity of data on the association between obesity and the future development of PAD or CLI.
Researchers, led by Kunihiro Matsushita, MD, PhD, of the Johns Hopkins School of Medicine in Baltimore, analyzed data of nearly 14,000 men and women who are currently enrolled in the ongoing Atherosclerosis Risk in Communities Study.
Matsushita and colleagues found 373 patients had incidences of PAD without CLI and 201 patients with PAD with CLI.
Incident PAD without CLI occurred in 3.4 percent of underweight individuals, 2.2 percent normal weight, 2.7 percent overweight, 3.4 percent obese and 2.6 percent severely obese. Incident PAD with CLI occurred in 0.8 percent underweight, 0.8 percent normal weight, 1.1 percent overweight, 2.3 percent obese and 3.6 percent severely obese individuals.
“Overall, our data suggest that there is a positive association of obesity with PAD and CLI independent of potential confounders, but that this relationship tends to be stronger for PAD with CLI,” the authors wrote.
The researchers found that people who were obese were 1.5 times more likely to develop PAD with CLI than those who were normal weight.
Higher BMI at baseline was associated with increased risk of PAD without CLI when BMI was modeled continuously and with PAD with CLI regardless of BMI being monitored categorically or continuously.
The associations of BMI with PAD without and with CLI were attenuated when accounting for potential mediators (diabetes, hypertension, etc.), and there was no longer a significant association between BMI and PAD without CLI. But PAD was associated with CLI, even after accounting for potential mediators.
The researchers noted the results support weight management of overweight and obese adults because it may reduce an individual's risk of PAD with CLI.
“Our findings suggest that obesity may play a role in the development and progression of peripheral artery disease and support the notion that both weight loss and medical management of obesity-related cardiovascular risk factors are essential for decreasing the risk of atherosclerotic disease,” Matsushita et al. concluded.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.