title: Ankle/arm blood pressure index: an insurance perspective.
abstract: Recent studies conclude that the ankle/arm blood pressure index (AAI) is a useful clinical tool for refining cardiovascular risk classification in the elderly. A reduction in the AAI to 0.9 or less is associated with increased risk for both coronary heart disease and total cardiovascular disease morbidity and mortality, as well as all-cause mortality. This relationship persists after adjusting for traditional risk factors and known cardiovascular disease. AAI will appear more common in attending physician's statements, prompting a need to educate underwriters about this technology. AAI may be of particular interest to insurers dealing in the elderly market, to those with strong physician examiner systems, and in markets where blood or urine tests are not commonly used in underwriting.
authors.affiliation: Swiss Reinsurance Group, Westport Connecticut, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Pokorski
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000191:economics / Q000379:methods; D002318:Cardiovascular Diseases / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D003327:Coronary Disease / Q000145:classification* / Q000401:mortality / Q000503:physiopathology; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007341:Insurance; D007348:Insurance, Health; D007866:Leg / Q000098:blood supply; D008297:Male; D009017:Morbidity; D009026:Mortality; D011237:Predictive Value of Tests; D012306:Risk; D012307:Risk Factors; D015996:Survival Rate