Race as a risk factor in the severity of infragenicular occlusive disease: Study of an urban hospital patient population

Document Type

Journal Article

Publication Date



Journal of Vascular Surgery








We retrospectively studied the arteriograms of 135 men admitted for evaluation of lower extremity ischemia to examine whether race influences the severity of infragenicular occlusive disease. The scoring system prepared by the Ad Hoc Committee on Reporting Standards for the Society for Vascular Surgery and the International Society for Cardiovascular Surgery was used to grade the severity of stenosis in each of the upper, middle, and lower thirds of the anterior and posterior tibial and peroneal arteries (collectively called "infragenicular" arteries). The patients were divided into two groups: 83 blacks (140 arteriogram limbs) and 52 whites (87 arteriogram limbs). Disease severity scores between the groups were compared, and the existence of five known risk factors for atherosclerosis were considered for poststratification adjustment. Results showed that higher disease scores, indicating more severe disease, were found in the black population in every segment of the infragenicular arteries. The mean (± SE) score for all the infragenicular segments in blacks was significantly higher than that in the whites (2.08 ± 0.05 vs 1.57 ± 0.06, p < 0.001). The black and white groups were comparable in terms of age (65.2 vs 64.6 years), prevalence of diabetes (20% vs 25%), smoking history (93% vs 90%), and hypercholesterolemia (51% vs 63%). Hypertension was more prevalent among the black patients (51% vs 27%, p < 0.001). When only the non-hypertensive patients in both groups were considered, however; the mean severity score was still significantly higher in blacks (2.10 ± 0.06 vs 1.42 ± 0.06, p < 0.001). These findings provide evidence that there are racial differences in the severity of infragenicular occlusive disease. Further investigation is needed to determine whether this is due to a genetic predisposition or is a result of unidentified environmental factors. © 1990.

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