Ankle/brachial blood pressure in men > 70 years of age and the risk of coronary heart disease

Low ankle/brachial blood pressure index (ABI) is a marker of generalized at herosclerosis in the elderly, although its association with coronary heart disease (CHD) has not been well established. The purpose of this report is to examine the relation between ABI and the risk of CHD in a sample of elde rly men, Findings are based on the ABI that was measured in 2,863 Japanese- American men aged 71 to 93 years at an examination that occurred from 1991 to 1993 in the Honolulu Heart Program. All men were free of total CHD at th at time and followed for nonfatal myocardial infarction and death from CHD over a 3- to 6-year period. During follow-up, 186 had a coronary event. Age -adjusted incidence declined significantly from 15.3% in men with an ABI <0 .8 to 5.4% in men with an ABI greater than or equal to 1.0 (p <0.001). The effect of ABI on disease was similar across a variety of risk factor strata , although it seemed strongest in the presence of hypertension and in past and current cigarette smokers. Adjustment for other risk factors failed to diminish the relation between ABI and CHD, We conclude that a low ABI incre ases the risk of CHD in elderly men. If findings can be extended to other e lderly population segments, simple measurement of ABI in an outpatient sett ing could be an important tool for assessing the risk of CHD in the elderly . (C) 2000 by Excerpta Medico, Inc.