Anxiety a possible peripheral artery disease risk factor among older Africans: The EPIDEMCA study.

Abstract Objective During the past ten years considerable progress has been made in research on cardiac effects of anxiety. On the other hand, epidemiological research on the implication of this psychosocial factor in the development of peripheral artery disease (PAD) is lacking. The present study sought to examine the association of anxiety and PAD in elderly individuals in two sub-Saharan countries in Africa.Methods This cross-sectional study, was performed in urban and rural population in Central Africa: Republic of Congo and Central African Republic. All individuals ≥65 years living in these areas were invited to participate. Socio-demographic data, medical history, medication, clinical and biological data were collected. Anxiety symptoms were assessed with the Geriatric Mental State version B3. Peripheral artery disease was defined as ankle brachial index (ABI) ≤0.90.Results A total of 1662 subjects composed our study population (age 72.9±6.5 years, 59.3% females). Overall, the prevalence of anxiety was 7.2%, significantly higher in women (9.2% vs. 4.3% in men, p<0.001 ). Independently of all confounding factors, anxiety was strongly associated with PAD in both countries (OR: 2.56, 99%CI: .52-4.20) and more frequently associated with PAD in women than in men (OR: 3.37, 95%CI: 1.22-4.10 vs. OR: 2.34, 95%CI: 1.13-5.06).Conclusion Our study underlines the high prevalence of anxiety in African general population in the elderly, as well as a significant association with the peripheral artery disease, independently of all possible confounding factors. The higher rates of anxiety in women and stronger association with PAD as compared to men might explain the higher rates of PAD in African women.