title: Decreased ankle/arm blood pressure index and mortality in elderly women.
abstract: OBJECTIVE
  To evaluate the relationship of the ankle/arm blood pressure index to short-term mortality in women 65 years of age or older.
  
  
  METHODS
  Prospective cohort study with average follow-up of 4.3 years.
  
  
  METHODS
  Rural community near Pittsburgh, Pa.
  
  
  METHODS
  A total of 1492 white women 65 years of age or older, living in the community and ambulatory without the help of another person.
  
  
  METHODS
  All-cause and cause-specific mortality.
  
  
  RESULTS
  The ankle/arm index (the systolic pressure in the posterior tibial artery divided by that in the brachial artery) was measured in 1986 through 1988 and found to be 0.9 or less in 82 (5.5%) of the women, 67 of whom reported no symptoms of claudication. Comparing women with an index of 0.9 or less with those with an index greater than 0.9, the relative risk for all-cause mortality 4 years later (after adjustment for age, smoking, and other risk factors) was 3.1 (95% confidence interval [Cl], 1.7 to 5.5); for heart disease, 3.7 (95% Cl, 1.2 to 11.6); for cardiovascular diseases, 4.0 (95% Cl, 1.3 to 8.5); for cancer, 3.3 (95% Cl, 1.3 to 8.5); and for all other causes, 1.1 (95% Cl, 0.1 to 9.2). Similar levels of risk were found after excluding women with symptoms of claudication and/or a history of cardiovascular disease at baseline.
  
  
  CONCLUSIONS
  Healthy, older women with an ankle/arm index of 0.9 or less are at high risk of death and therefore may be considered for aggressive therapy to modify cardiovascular risk factors.
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pa 15261.
authors.forename: M T
authors.initials: MT
authors.lastname: Vogt
authors.forename: J A
authors.initials: JA
authors.lastname: Cauley
authors.forename: A B
authors.initials: AB
authors.lastname: Newman
authors.forename: L H
authors.initials: LH
authors.lastname: Kuller
authors.forename: S B
authors.initials: SB
authors.lastname: Hulley
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000502:physiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D009026:Mortality; D010414:Pennsylvania / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D013599:Systole; D016909:Tibial Arteries / Q000502:physiology