Mt. Vogt et al., THE RELATIONSHIP BETWEEN ANKLE BRACHIAL INDEX, OTHER ATHEROSCLEROTIC DISEASE, DIABETES, SMOKING AND MORTALITY IN OLDER MEN AND WOMEN, Atherosclerosis, 101(2), 1993, pp. 191-202
The goal of this study is to investigate the relationship between peri
pheral arterial disease and mortality in a large patient population an
d assess the effects of other atherosclerotic diseases, diabetes and s
moking on this relationship. All patients, 50 years or older and with
no history of lower extremity surgery, evaluated for lower extremity a
rterial disease in a university hospital peripheral vascular laborator
y over a 13-year period (1977-1989) were included in the study (n = 19
30). Arterial disease was assessed by measurement of the resting ankle
brachial index (ABI) in these patients. The ABI was calculated by div
iding the systolic pressure in the tibial arteries by the pressure in
the brachial artery. Analyses of the data by use of multivariate stati
stical techniques and by stratification of the patient population by c
o-morbid condition indicate that ABI is a robust and independent predi
ctor of all-cause mortality in both men (relative risk (RR) = 1.6,95%
confidence interval (CI) 1.3,2.0) and women (RR = 1.9,95% CI 1.4, 2.4)
. The relative risks are essentially unchanged after exclusion of all
patients with clinical history of cardiovascular disease or diabetes.
Similarly, a low ABI is an important risk factor for mortality among p
atients with a history of stroke, angina or diabetes; men and women wi
th a history of smoking and women who are non-smokers. Therefore, the
measurement of ABI, a simple, objective, non-invasive technique which
can be used in the physician's office, may be useful for early identif
ication of patients at high risk for morbidity and mortality.