title: Differences in the ankle-brachial index in the general population after 4 years of follow-up.
abstract: BACKGROUND
  Variation in the ankle-brachial index (ABI) is related to the progression of atherosclerosis in the lower extremities and is associated with mid-term cardiovascular morbidity and mortality. The aim of this study was to investigate the changes in ABI after four years of follow-up of individuals in the general population, and the factors associated with relevant variations observed.
  
  
  METHODS
  The study was performed in 750 volunteers (mean age 69.9 years) men without any evidence of peripheral artery disease, who attended a primary care centre. A complete physical examination, together with standard blood tests and ABI were performed. Four years later a new clinical evaluation was done. Variations in ABI values were considered relevant if > 10 %.
  
  
  RESULTS
  Mean ABI in the second visit was 1.07 ± 0.15, which represented 0.02 ± 0.12 points lower than in the first visit (P < 0.001). Of these subjects, 157 (21.6 %) had an ABI decrease > 10 %. Multivariate analysis showed that the change was associated with male gender, cardiovascular history, no intake of blockers of the renin-angiotensin system, and the presence of atherogenic dyslipidaemia. A relevant increase in ABI was observed in 117 subjects (16.1 %), but was not associated with any of the studied factors.
  
  
  CONCLUSIONS
  ABI values tend to decrease in the general population, although one sixth of the studied subjects had a relevant increase in this parameter.
authors.affiliation: Hospital Carlos III, Madrid, Spain. clahoz.hcii@salud.madrid.org
authors.forename: Carlos
authors.initials: C
authors.lastname: Lahoz
authors.forename: Teresa
authors.initials: T
authors.lastname: Garcia-Fernandez
authors.forename: Maria
authors.initials: M
authors.lastname: Barrionuevo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Vicente
authors.forename: Teresa
authors.initials: T
authors.lastname: Gonzalez-Alegre
authors.forename: José M
authors.initials: JM
authors.lastname: Mostaza
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D016009:Chi-Square Distribution; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D011320:Primary Health Care; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors