title: Influence of multiple blood pressure measurements on the estimation of the ankle-brachial index and the consequent diagnosis of peripheral artery disease.
abstract: OBJECTIVE
  The ankle-brachial index (ABI) is the most useful and efficient tool for assessing the presence of peripheral artery disease (PAD). The aim of this study was to evaluate the effect of multiple sequential blood pressure (BP) measurements on the estimation of the ABI and the consequent diagnosis of PAD in a high vascular risk population.
  
  
  METHODS
  This is a cross-sectional study of 71 patients admitted to the Cardiology Department or evaluated as outpatients in the Internal Medicine Department at our institution. The ABI was calculated with the first blood pressure (BP) measurement in the arm with the higher BP (dominant arm; method A) and with the average of the second and third measurements in that same arm (method B). The results of both methods were compared.
  
  
  RESULTS
  No statistically significant difference was found for the numerical value of ABI between the methods. The κ correlation index for agreement in the diagnosis of PAD between the methods was 0.87 (95% confidence interval: 0.74-0.99).
  
  
  CONCLUSIONS
  Multiple BP measurements had no impact on the final ABI or on the subsequent diagnosis of PAD.
authors.affiliation: Vascular Risk Unit, Internal Medicine Department, Fundación de Investigación Biomédica, Hospital Universitario La Princesa, Madrid, Spain. diego.realdeasua@gmail.com
authors.forename: Diego
authors.initials: D
authors.lastname: Real de Asúa
authors.forename: Ramón
authors.initials: R
authors.lastname: Puchades
authors.forename: Iluminada
authors.initials: I
authors.lastname: García-Polo
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods* / Q000592:standards*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000503:physiopathology*