title: Effects of age, sex and smoking on ankle-brachial index in a Finnish population at risk for cardiovascular disease.
abstract: BACKGROUND
  Smoking is a well-known risk factor for peripheral arterial disease (PAD). Data regarding differences in the prevalence of PAD between sexes are somewhat controversial. In addition, most studies indicate that the prevalence of PAD increases with age in both sexes. In the present study, the effects of sex, age and smoking on the ankle-brachial index (ABI) in a Finnish cardiovascular risk population were investigated.
  
  
  OBJECTIVE
  To investigate the relationship between the ankle-brachial index, and age, sex and smoking in a Finnish population at risk for cardiovascular disease.
  
  
  METHODS
  All men and women between 45 and 70 years of age living in a rural town (Harjavalta, Finland; total population 7700) were invited to participate in a population survey (Harmonica study). Patients with previously diagnosed diabetes or vascular disease were excluded. In total, 2856 patients were invited to participate in the study. From these subjects, a cardiovascular risk population was screened. Complete data were available from 1028 persons. ABI (the ratio between the posterior tibial or dorsalis pedis artery and brachial artery pressures) was measured, and questionnaires were used to detect smoking status and relevant medical history. Only current smoking status was taken into account.
  
  
  RESULTS
  The mean ABI for the entire study population was 1.10 (range 0.56 to 1.64). Current smokers had a lower mean ABI (1.06; P<0.001). There was no statistically significant difference in ABI values among age groups, although the majority of patients with ABI values below 0.9 were older than 60 years of age. There was no statistically significant difference in ABI between sexes.
  
  
  CONCLUSIONS
  As previously reported, the present study shows the significant effect of smoking in the development of PAD. No statistically significant difference was found among age groups, but the tendency was toward lower ABIs in the oldest age groups. Sex had a minimal effect on the ABI.
authors.affiliation: Department of Surgery.
authors.forename: Kari
authors.initials: K
authors.lastname: Syvänen
authors.forename: Pertti
authors.initials: P
authors.lastname: Aarnio
authors.forename: Pekka
authors.initials: P
authors.lastname: Jaatinen
authors.forename: Päivi
authors.initials: P
authors.lastname: Korhonen