This project will use UK Biobank to investigate how vascular ageing and lifestyle factors jointly influence the development and consequences of peripheral artery disease (PAD).
The main research questions are:
(1) Are markers of vascular ageing, such as arterial stiffness index, pulse pressure and aortic measures in the imaging subset, associated with prevalent and incident PAD?
(2) How are lifestyle factors (smoking, physical activity, adiposity and diet-related indicators) related to PAD risk, and to what extent are these associations mediated or modified by vascular ageing?
(3) What is the impact of PAD on subsequent physical functioning and frailty, including walking pace, grip strength, falls and mortality?
Using data from approximately 500,000 adults aged 40-69 years at recruitment, we will perform multivariable regression and survival analyses to estimate these associations, adjusting for sociodemographic and cardiometabolic confounders. Longitudinal models will be used to examine trajectories of physical capability after PAD onset.
The scientific rationale is that PAD is a major, but often under-recognised, manifestation of systemic atherosclerosis. Vascular ageing may provide an integrated measure of cumulative vascular damage and could help identify individuals at particularly high risk when combined with lifestyle information. Understanding how PAD affects functional decline and frailty is also critical for planning prevention and rehabilitation strategies in ageing populations.