title: Association of interankle systolic blood pressure difference with peripheral vascular disease and left ventricular mass index.
abstract: BACKGROUND
  An interankle systolic blood pressure (SBP) difference has been associated with overall and cardiovascular mortality. We investigated whether an association existed between this difference and ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and echocardiographic parameters.
  
  
  METHODS
  A total of 1,059 patients referred for echocardiographic examination were included in the study. The 4 limb blood pressures were measured simultaneously using an ABI-form device.
  
  
  RESULTS
  We performed multivariate forward analysis to determine the factors associated with an interankle SBP difference ≥ 15mm Hg. An ABI < 0.9 (P < 0.001), high baPWV (P < 0.001), and increased left ventricular mass index (LVMI; P = 0.004) were associated with an interankle SBP difference ≥ 15mm Hg. Also, the addition of an interankle SBP difference ≥ 15mm Hg to a model of clinical features could significantly improve the value in predicting ABI < 0.9 (P < 0.001) and increased LVMI (P = 0.036).
  
  
  CONCLUSIONS
  Our study demonstrated that ABI < 0.9, high baPWV, and increased LVMI were independently associated with an interankle SBP difference ≥ 15mm Hg. Also, an interankle SBP difference ≥ 15mm Hg could offer an extra benefit in identifying patients with ABI < 0.9 and increased LVMI beyond conventional clinical features. Hence, calculation of interankle SBP difference may provide additional information for identifying patients with peripheral vascular disease and increased LVMI.
authors: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors: Ho-Ming
authors: HM
authors: Su
authors: Tsung-Hsien
authors: TH
authors: Lin
authors: Po-Chao
authors: PC
authors: Hsu
authors: Wen-Hsien
authors: WH
authors: Lee
authors: Chun-Yuan
authors: CY
authors: Chu
authors: Szu-Chia
authors: SC
authors: Chen
authors: Chee-Siong
authors: CS
authors: Lee
authors: Wen-Chol
authors: WC
authors: Voon
authors: Wen-Ter
authors: WT
authors: Lai
authors: Sheng-Hsiung
authors: SH
authors: Sheu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012307:Risk Factors
keywords: ankle-brachial index; blood pressure; brachial-ankle pulse wave velocity; hypertension; interankle systolic blood pressure difference.; left ventricular mass index