title: Low pulse-wave amplitude during reactive leg hyperaemia: an independent, early marker for ischaemic heart disease and death. Results from the 21-year follow-up of the prospective cohort study 'Men born in 1914', Malmö, Sweden.
abstract: OBJECTIVE
  To study the incidence of myocardial infarction, all-cause mortality and mortality from ischaemic heart disease in relation to arterial leg blood flow determined by venous occlusion plethysmography of the calf.
  
  
  METHODS
  A prospective cohort study 'Men born in 1914'.
  
  
  METHODS
  Malmö, a city in southern Sweden with 256,000 inhabitants, and a single referral hospital.
  
  
  METHODS
  Six-hundred and thirty-six 55-year-old men, randomly selected from the general population. None of them had signs or symptoms of leg artery disease.
  
  
  METHODS
  All-cause mortality, morbidity and mortality from ischaemic heart disease during 21 years of follow-up following the initial examination in 1968.
  
  
  RESULTS
  A low pulse-wave amplitude (i.e. < 5 mm) during reactive hyperaemia was, independently of other known arteriosclerotic risk factors, associated with a higher cardiac event rate of 37.1% (relative risk: 2.2; 95% CI: 1.3-3.6) and a higher all-cause mortality rate of 62.9% (relative risk: 1.7; 95% CI: 1.2-2.4) during 21 years of follow-up. No other plethysmographically recorded variable was associated with an increased mortality and cardiac event rate.
  
  
  CONCLUSIONS
  The plethysmographically recorded pulse-wave amplitude during reactive hyperaemia can be used as an early independent marker to identify individuals at risk of developing ischaemic heart disease and death at an early age.
authors.affiliation: Department of Community Health Sciences, Lund University, Malmö General Hospital, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Hedblad
authors.forename: M
authors.initials: M
authors.lastname: Ogren
authors.forename: L
authors.initials: L
authors.lastname: Janzon
authors.forename: S O
authors.initials: SO
authors.lastname: Isacsson
authors.forename: S E
authors.initials: SE
authors.lastname: Lindell
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D006940:Hyperemia / Q000150:complications*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000209:etiology* / Q000401:mortality*; D010991:Plethysmography; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology