Background and Purpose— The age-adjusted stroke mortality rate in Japan was the highest in the world from 1950 to the 1970s, but it started to dramatically decrease after 1965. In addition to improved management of high blood pressure, the increase in average height might also contribute to this reduction. The present study investigates whether height is an independent risk for stroke mortality in Japan. Methods— Among participants of the National Survey on Cardiovascular Diseases in 1980 who were randomly selected from the Japanese population, we followed up 3969 and 4955 Japanese men and women without prior cardiovascular disease for a maximum of 19 years and observed 158 and 132 stroke deaths. Results— Height was inversely correlated with age and with crude stroke mortality. The relationship was attenuated in men when we adjusted for age or other possible confounders (multivariate adjusted relative hazards of a 5-cm increase of height for stroke mortality: 0.92, 95% CI: 0.79 to 1.08). For women, the in...

Relation of Adult Height With Stroke Mortality in Japan

Type 2 diabetes (T2D) and lower-extremity peripheral artery disease (PAD) are growing global health problems associated with considerable cardiovascular (CV) and limb-related morbidity and mortality, poor quality of life and high healthcare resource use and costs. Diabetes is a well-known risk factor for PAD, and the occurrence of PAD in people with T2D further increases the risk of long-term complications. As the available evidence is primarily focused on the overall PAD population, we undertook a systematic review to describe the burden of comorbid PAD in people with T2D. The MEDLINE, Embase and Cochrane Library databases were searched for studies including people with T2D and comorbid PAD published from 2012 to November 2021, with no restriction on PAD definition, study design or country. Hand searching of conference proceedings, reference lists of included publications and relevant identified reviews and global burden of disease reports complemented the searches. We identified 86 eligible studies, mostly observational and conducted in Asia and Europe, presenting data on the epidemiology (n = 62) and on the clinical (n = 29), humanistic (n = 12) and economic burden (n = 12) of PAD in people with T2D. The most common definition of PAD relied on ankle-brachial index values ≤ 0.9 (alone or with other parameters). Incidence and prevalence varied substantially across studies; nonetheless, four large multinational randomised controlled trials found that 12.5%-22% of people with T2D had comorbid PAD. The presence of PAD in people with T2D was a major cause of lower-limb and CV complications and of all-cause and CV mortality. Overall, PAD was associated with poor quality of life, and with substantial healthcare resource use and costs. To our knowledge, this systematic review provides the most comprehensive overview of the evidence on the burden of PAD in people with T2D to date. In this population, there is an urgent unmet need for disease-modifying agents to improve outcomes. 

Epidemiology and Burden of Peripheral Artery Disease in People With Type 2 Diabetes: A Systematic Literature Review


Background: The objective of this investigation was to evaluate adverse short-term outcomes following open lower extremity bypass surgery in subjects with diabetes mellitus with a specific comparison performed based on subject height.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select those subjects with CPT codes 35533, 35540, 35556, 35558, 35565, 35566, 35570 and 35571 and with the diagnosis of diabetes mellitus. This resulted in 83 subjects ≤60 inches, 1084 subjects >60 inches and <72 inches, and 211 subjects ≥72 inches.
Results: No differences were observed between groups with respect to the development of a superficial surgical site infection (9.6% vs. vs. 6.4% vs. 5.7%; p=0.458), deep incisional infection (1.2% vs. 1.4% vs. 2.8%; p=0.289), sepsis (2.4% vs. 2.0% vs. 2.8%; p=0.751), unplanned reoperation (19.3% vs. 15.6% vs. 21.8%; p=0.071), nor unplanned hospital readmission (19.3% vs. 14.8% vs. 17.1%; p=0.573). A significant difference was observed between groups with respect to the development of a wound disruption (4.8% vs. 1.3% vs. 4.7%; p=0.001). A multivariate regression analysis was performed of the wound disruption outcome with the age, gender, race, ethnicity, height, weight, current smoker and open wound/wound infection variables. Race (p=0.025) and weight (p=0.003) were found to be independently associated with wound disruption, but height was not (p=0.701).
Conclusions: The results of this investigation demonstrate no significant difference in short-term adverse outcomes following the performance of lower extremity bypass surgery based on patient height.

The Effect of Height on Adverse Short-Term Outcomes Following Lower-Extremity Bypass Surgery in Subjects with Diabetes Mellitus

Objectives: The main aim of the study was to find the association between obesity and other anthropometric indices with symptomatic peripheral arterial disease (PAD) in type 2 diabetes mellitus (T2DM) patients. Furthermore, we investigated other risk factors of symptomatic PAD in T2DM.
Study Design: In a case-control design, 46 cases and 69 controls were enrolled, aged between 40 and 75 years. Cases were age and gender matched with controls. Ankle-brachial index (ABI) <0.9 was a proxy for PAD in T2DM patients. Anthropometric indices were measured and known cardiovascular risk factors were collected, area under curve (AUC) and logistic regression were applied.
Results: Hypertensive patients had 2.5 fold higher risk of symptomatic PAD than normotensive patients, (CI 95%=1.16-5.51). Smoking habit was remarkably higher in cases than controls, OR=8.2 CI 95% (3.2-8.2), however this was not significant in smoking subgroups based on duration of smoking (pack-year). Waste hip ratio (WHR) ≥1 in both male and female was significantly related to the outcome, Odds ratio 3.12 (CI 95% 1.25-7.82) in men and of 26.67 (CI 95% 3.77-188.51) in women. In the final model (forward stepwise regression), WHR ≥ 1, hypertension, duration of DM and Smoking were significantly related to symptomatic PAD.
Conclusion: As obese patients are more prone to type 2 diabetes mellitus, the previous cut-offs of obesity may change in the future to assess the risk of CVD in this group. We suggest that WHR is a simple measure of abdominal obesity and is related to symptomatic PAD.

/pdf/evaluating-the-association-between-anthropometric-indices-2kpskdqjgv.pdf

Evaluating the Association between Anthropometric Indices and Cardiovascular Risk Factors with Symptomatic Peripheral Arterial Disease in Type 2 Diabetes Mellitus


Background: The objective of this investigation was to evaluate adverse short-term outcomes following partial forefoot amputation with a specific comparison performed based on subject height.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select those subjects with a 28805 CPT code (amputation, foot; transmetatarsal) that underwent the procedure with “all layers of incision (deep and superficial) fully closed.” This resulted in 11 subjects with a height ≤60 inches, 202 subjects with a height >60 inches and <72 inches, and 55 subjects ≥72 inches. 
Results: Results of the primary outcome measures found no significant differences between groups with respect to the development of a superficial surgical site infection (0.0% vs. 6.4% vs. 5.5%; p=0.669), deep incisional infection (9.1% vs. 3.5% vs. 10.9%; p=0.076), or wound disruption (0.0% vs. 5.4% vs. 5.5%; p=0.730). Additionally, no significant differences were observed between groups with respect to unplanned reoperations (9.1% vs. 16.8% vs. 12.7%; p=0.0630) or unplanned hospital readmissions (45.5% vs. 23.3% vs. 20.0%; p=0.190).
Conclusions: The results of this investigation demonstrate no difference in short-term adverse outcomes following the performance of partial forefoot amputation with primary closure based on subject height. Although height has previously been described as a potential risk factor in the development of lower extremity pathogenesis, this finding was not observed in this study from a large US database.

A Comparison of Adverse Short-Term Outcomes Following Forefoot Amputation Based on Subject Height

Objective
To investigate whether height is associated with peripheral arterial disease (PAD) in patients with type 2 diabetes.

/pdf/association-of-height-with-peripheral-arterial-disease-in-4xjxuz45w6.pdf

Association of height with peripheral arterial disease in type 2 diabetes.

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Association of height with peripheral arterial disease in type 2 diabetes.