Key result
Midlife smoking and hypertension linked to ~160% higher PAD risk, though selective mortality biases assessments.
Cohort
Odds Ratio: 2.6 (95% CI 1.3–5.4)
Prospective assessment of risk factors for peripheral arterial disease can be significantly biased by changes in risk factor exposure over time and the selective mortality of high-risk individuals.
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May bias survivor-based PAD risk estimates; leaves open whether adjustments mitigate distortion in contemporary cohorts.
Ögren et al. (1996) conducted a cohort in Peripheral arterial disease (PAD). Smoking and hypertension vs. Non-smokers and normotensive men was evaluated on Peripheral arterial disease (ankle-brachial pressure index < 0.9) at age 68 (OR 2.6, 95% CI 1.3-5.4). Smoking and hypertension at age 55 were associated with high mortality before age 68 (26% and 31%, respectively), demonstrating that selective mortality biases prospective risk factor assessments.
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