A high burden of diabetes and ankle brachial index abnormalities exists in Mexican Americans in South Texas

Anand Prasad, Audrey C. Choh, Nelson D. Gonzalez, Marlene Garcia, Miryoung Lee, Gordon Watt, Liliana Maria Vasquez, Susan Laing, Shenghui Wu, Joseph B. McCormick, Susan Fisher-Hoch

Research output: Contribution to journalArticlepeer-review


Ethnic differences exist in the United States in the interrelated problems of diabetes (DM), peripheral arterial disease (PAD), and leg amputations. The purpose of this study was to determine the prevalence and risk factor associations for subclinical PAD in a population sample of Mexican Americans using the ankle brachial (ABI) index. The ABI-High (higher of the two ankle pressures/highest brachial pressure) and ABI-Low (lower of the two ankle pressures/highest brachial pressure) were calculated to define PAD. Toe brachial index (TBI) was also calculated. 746 participants were included with an age of 53.4 ± 0.9 years, 28.3 % had diabetes mellitus (DM), 12.6 % were smokers, and 51.2 % had hypertension (HTN). Using ABI-High ≤ 0.9, the prevalence of PAD was 2.7 %. This rose to 12.7 % when an ABI-Low ≤ 0.9 was used; 4.0 % of the population had an ABI-High > 1.4. The prevalence of TBI < 0.7 was 3.9 %. DM was a significant risk factor for ABI-High ≤ 0.9 and ABI-High > 1.4, and TBI < 0.7. Increased age, HTN, smoking was associated with ABI-High ≤ 0.9, while being male was associated with ABI-High > 1.4. Increased age, smoking, and lower education were all associated with abnormal TBI. Despite relatively younger mean age than other studied Hispanic cohorts, the present population has a high burden of ABI abnormalities. DM was a consistent risk factor for PAD. These abnormalities indicate an important underlying substrate of vascular and metabolic disease that may predispose this population to the development of symptomatic PAD and incident amputations.

Original languageEnglish (US)
Article number102604
JournalPreventive Medicine Reports
StatePublished - Feb 2024


  • Amputation
  • Ankle brachial index
  • Diabetes mellitus
  • Doppler ultrasound
  • Peripheral arterial disease
  • Population health
  • Vascular medicine

ASJC Scopus subject areas

  • Health Informatics
  • Public Health, Environmental and Occupational Health


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