Ankle-arm index as an indicator of atherosclerosis: Its application as a screening method

ankle-arm blood pressure index (AAI) is seldom used to screen for atheroscl erotic diseases other than lower extremity arterial disease. This study was conducted to investigate whether the AAI can be used as a screening test f or atherosclerotic diseases in general. The subjects were 446 male workers in a copper smelter. Fundoscopic examinations, electrocardiograms, serum ch olesterol and triglyceride measurements, and AAI measurements were conducte d. Information on past medical histories of diabetes mellitus and ischemic heart disease, smoking, alcohol intake, duration of sleep and physical acti vity were collected. The AAI correlated well with the results of the fundos copic examinations, and an AAI of 1.00 gave the maximum sensitivity specifi city product. The same AAI value also gave the maximum products for ST segm ent depression in electrocardiograms and the past history of ischemic heart disease. Multiple logistic regression analysis showed that a low AAI value was related to higher systolic brood pressure and current smoking but was inversely related to alcohol intake. Our study validated the AAI in predict ing persons with risk factors of atherosclerotic diseases. The AAI measurem ents can be conducted at low cost, using simple techniques, and are noninva sive. We propose that the AAI be widely used to screen for atherosclerotic diseases, J CLIN EPIDEMIOL 51;12:1263-1269, 1998. (C) 1998 Elsevier Science Inc.