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The relationship between ankle-arm index and mortality in older men and women
M T Vogt1, M McKenna, S J Anderson
1Department of Epidemiology, Graduate School of Public Health, Univ. of Pittsburgh, PA 15261.
Insights
A lower ankle-arm blood pressure index predicts increased mortality from atherosclerotic heart disease in older adults. This simple test can identify high-risk individuals needing intervention.
Area of Science:
- Cardiovascular Medicine
- Geriatrics
- Vascular Health
Background:
- Peripheral artery disease (PAD) is a growing concern in aging populations.
- Early detection of PAD risk factors is crucial for preventing cardiovascular events.
Purpose of the Study:
- To investigate the ankle-arm blood pressure index (AAI) as a predictor of mortality in individuals aged 50 and older.
- To assess the prognostic value of AAI for all-cause and cause-specific mortality.
Main Methods:
- A 13-year prospective cohort study involving 1,930 patients (1,027 men, 903 women) aged 50+ referred for arterial evaluation.
- Data collection included all-cause and cause-specific mortality outcomes.
- Ankle-arm blood pressure index was measured in a hospital-based peripheral vascular laboratory.
Main Results:
- A decreased ankle-arm index was a significant independent predictor of all-cause mortality in both men and women.
- The ankle-arm index strongly predicted mortality from atherosclerotic heart disease, with risk inversely proportional to the index.
- No association was observed between the ankle-arm index and mortality from stroke or cancer.
Conclusions:
- A reduced ankle-arm index holds significant prognostic value for atherosclerotic heart disease mortality in older adults.
- Measuring the ankle-arm index can help identify high-risk patients who may benefit from proactive medical management.
- This non-invasive test offers a valuable tool for risk stratification in geriatric cardiovascular care.
Objective:
To determine whether the ankle-arm blood pressure index is a useful predictor of mortality in a large group of patients aged 50 or older.
Design:
Cohort study over a 13-year period.
Setting:
Peripheral vascular laboratory in a hospital affiliated with an academic health center.
Participants:
1,027 male and 903 female patients referred for arterial evaluation.
Outcome Measures:
All-cause and cause-specific mortality.
Results:
A decrease in ankle-arm index was a strong independent predictor of all-cause mortality [relative risk (RR) for men = 1.8(95% CI 1.5, 1.9); for women = 1.5, (1.2, 2.0)] and atherosclerotic heart disease mortality [RR for men = 2.0 (1.4, 2.9); for women = 2.1 (1.4, 3.1)]. The risk of mortality was inversely proportional to the ankle-arm index. No relationship was found between the index and mortality due to stroke or cancer.
Conclusions:
These results suggest that a decreased ankle-arm index has important prognostic significance for mortality due to atherosclerotic heart disease in older men and women. Measurement of this index may be useful in identifying those at high risk who may benefit from aggressive therapeutic intervention.