THE RELATIONSHIP BETWEEN ANKLE-ARM INDEX AND MORTALITY IN OLDER MEN AND WOMEN

Objective: To determine whether the ankle-arm blood pressure index is a useful predictor of mortality in a large group of patients aged 50 o r older. Design: Cohort study over a 13-year period. Setting: Peripher al vascular laboratory in a hospital affiliated with an academic healt h center. Participants: 1,027 male and 903 female patients referred fo r arterial evaluation. Outcome Measures: All-cause and cause-specific mortality. Results: A decrease in ankle-arm index was a strong indepen dent predictor of all-cause mortality [relative risk (RR) for men = 1. 8(95% CI 1.5, 1.9); for women = 1.5, (1.2, 2.0)] and atherosclerotic h eart disease mortality [RR for men = 2.0 (1.4, 2.9); for women = 2.1 ( 1.4, 3.1)]. The risk of mortality was inversely proportional to the an kle-arm index. No relationship was found between the index and mortali ty due to stroke or cancer. Conclusions: These results suggest that a decreased ankle-arm index has important prognostic significance for mo rtality due to atherosclerotic heart disease in older men and women. M easurement of this index may be useful in identifying those at high ri sk who may benefit from aggressive therapeutic intervention.