COMPARISON OF 3 BLOOD-PRESSURE METHODS USED FOR DETERMINING ANKLE BRACHIAL INDEX IN PATIENTS WITH INTERMITTENT CLAUDICATION/

The standard noninvasive test to assess the severity of peripheral art erial occlusive disease (PAOD) is the ankle/brachial systolic blood pr essure index (ABI). While ankle systolic blood pressure is obtained by the Doppler ultrasound technique, brachial systolic blood pressure ca n be obtained by the Doppler, auscultatory, or oscillometric (Dinamap 1846 SX) methods. The purpose was to determine whether the three metho ds yielded similar brachial systolic blood pressure values, and conseq uently similar ABI values, in PAOD patients with intermittent claudica tion. Fifty patients who had a history of intermittent claudication of 2.3 +/- 2.0 blocks for a duration of 5.7 +/- 5.8 years were recruited . Following 10 minutes of supine rest, brachial systolic blood pressur e was measured in the right arm by the three techniques in a randomize d order, and ankle systolic blood pressure (87.3 +/- 28.9 mmHg) was me asured in the more symptomatic leg with the Doppler technique. Brachia l systolic blood pressure was not significantly different (p=0.954) am ong the Doppler (128.5 +/- 18.4 mmHg), auscultatory(128.4 +/- 17.4 mmH g), and oscillometric (128.2 +/- 17.1 mmHg) methods. Corresponding ABI values also were similar (p=0.922) among the three respective methods (0.68 +/- 0.22, 0.68 +/- 0.22, and 0.68 +/- 0.21), indicating that AB I did not vary according to the technique used to obtain brachial syst olic blood pressure. It is concluded that the accuracy of determining ABI in PAOD patients with intermittent claudication was minimally affe cted by the method chosen to obtain brachial systolic blood pressure.