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Updated: Jan 2, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Relation between high Ankle-Brachial Index and cardiovascular outcomes in the general population and cardiovascular
Yu Yang1, Longguang Liu1, Hongxiao Sun1
1Department of Vascular and Thyroid Surgery, The First Affiliated Hospital, China Medical University, Shenyang, China.
Insights
An abnormally high Ankle-Brachial Index (ABI) is linked to increased cardiovascular mortality in patients with existing cardiovascular disease (CVD). However, this association was not found in the general population, warranting further research.
Area of Science:
- Cardiology
- Vascular Medicine
- Epidemiology
Background:
- Conflicting research exists regarding the association between a high Ankle-Brachial Index (ABI) and cardiovascular outcomes.
- This meta-analysis investigates the link between an abnormally high ABI and cardiovascular events.
Purpose of the Study:
- To assess the association between an abnormally high ABI and cardiovascular outcomes.
- To differentiate findings between the general population and patients with suspected or established cardiovascular disease (CVD).
Main Methods:
- A systematic literature search was performed on PubMed and Embase databases up to November 10th, 2018.
- Included were observational studies examining high ABI (>1.3 or >1.4) and cardiovascular events (stroke, coronary heart disease, heart failure, CVD/all-cause mortality).
- Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model.
Main Results:
- Ten cohort studies with 39,421 participants were analyzed.
- A high ABI was associated with increased CVD/all-cause mortality in patients with CVD (RR 1.26; 95% CI 1.03-1.55).
- No significant increase in stroke or coronary heart disease risk was observed in the general population with a high ABI.
Conclusions:
- An abnormally high ABI is associated with higher CVD/all-cause mortality risk in individuals with existing CVD.
- This association was not evident in the general population.
- Further well-designed studies are recommended to validate these findings.
Introduction:
Conflicting findings have been reported on the association between high Ankle-Brachial Index (ABI) and cardiovascular outcomes. This meta-analysis aimed to assess the association of abnormally high ABI and cardiovascular outcomes in the general population and suspected or established cardiovascular disease (CVD) patients.
Evidence Acquisition:
A comprehensive literature search was conducted in PubMed and Embase databases through November 10th, 2018. All observational studies evaluating the association of high ABI with cardiovascular events including stroke, coronary heart disease (CHD), congestive heart failure, and composite of CVD/all-cause mortality in the general population and suspected or established CVD patients were included. We pooled risk ratios (RR) with 95% confidence intervals (CI) for the abnormally high ABI (> 1.3 or >1.4) versus the reference normal ABI category.
Evidence Synthesis:
We identified 10 cohort studies enrolling 39,421 participants. A random effect model meta-analysis indicated that the pooled RR of composite of CVD/all-cause mortality was 1.07 (95% CI 0.83-1.38) in the general population and 1.26 (95% CI 1.03-1.55) in suspected or established CVD patients. Moreover, participants with abnormally high ABI did not increase the risk of stroke (RR 1.60; 95% CI 0.83-3.06) and CHD (RR 1.40; 95% CI 0.87-2.24) in the general population.
Conclusions:
Abnormally high ABI appears to be associated with an increased risk of a composite of CVD/all-cause mortality in suspected or established CVD patients but not in the general population. However, additional well-designed studies are required to support the current findings.
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