The relevance of different methods of calculating the ankle-brachial index: the multi-ethnic study of atherosclerosis.
The authors aimed to determine differences in the prevalence of peripheral arterial disease (PAD) and its associations with cardiovascular disease (CVD) risk factors, using different methods of calculating the ankle-brachial index (ABI). Using measurements taken in the bilateral brachial, dorsalis pedis, and posterior tibial arteries, the authors calculated ABI in 3 ways: 1) with the lowest ankle pressure (dorsalis pedis artery or posterior tibial artery) ("ABI-LO"), 2) with the highest ankle pressure ("ABI-HI"), and 3) with the mean of the ankle pressures ("ABI-MN"). For all 3 methods, the index ABI was the lower of the ABIs calculated from the left and right legs. PAD was defined as an ABI less than 0.90. Among 6,590 subjects from a multiethnic cohort (baseline examination: 2000-2002), in comparison with ABI-HI, the relative prevalence of PAD was 3.95 times higher in women and 2.74 times higher in men when ABI-LO was used. The relative magnitudes of the associations were largest between PAD and both subclinical atherosclerosis and CVD risk factors when ABI-HI was used, except when risk estimates for PAD were less than 1.0, where the largest relative magnitudes of association were found using ABI-LO. PAD prevalence and its associations with CVD risk factors and subclinical atherosclerosis measures depend on the ankle pressure used to compute the ABI.
Allison
Matthew A
MA
Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, Mailcode 0811, La Jolla, CA 92093-0811, USA. mallison@ucsd.edu
Aboyans
Victor
V
Granston
Tanya
T
McDermott
Mary M
MM
Kamineni
Aruna
A
Ni
Hanyu
H
Criqui
Michael H
MH
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index / Q000379:methods*; D001213:Asian; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012307:Risk Factors; D044465:White People