title: Cardiovascular morbidity-mortality associated to ankle-brachial index in the general population.
abstract: OBJECTIVE
  Abnormal ankle-brachial index (ABI) is associated with a high risk of cardiovascular disease. This study has aimed to investigate the association between low ABI and risk of cardiovascular death in a general population attended in a primary care center.
  
  
  METHODS
  A total of 1,361 volunteers aged between 60 and 79 years without any evidence of peripheral artery disease who attended a primary care center participated in the study. They underwent a complete physical examination, together with standard blood tests and ABI was determined. The participants were contacted by telephone 4 years later and asked about any cardiovascular problems for that period. Causes of death and hospitalization were confirmed in the medical records in the primary care center and/or hospital.
  
  
  RESULTS
  Information was obtained about the clinical evolution of 1,300 participants (mean age 69.9 years, 38.2% men). Mean follow-up was 49.8 months. There were 13 cardiovascular death and 49 major cardiovascular events. Low ABI (<0.9) was associated with a significant higher risk of cardiovascular death (adjusted relative risk 6.83; 95% confidence interval 1.36-34.30, P=.020), and with a higher risk of major cardiovascular events (adjusted relative risk 2.42; 95% confidence interval 0.99-5.91, P=.051). High or uncompressible ABI was not associated with higher cardiovascular risk.
  
  
  CONCLUSIONS
  A low ABI was associated with higher risk of cardiovascular death in the general population followed-up in a primary care center.
authors.affiliation: Unidad de Lípidos y Riesgo Cardiovascular, Hospital Carlos III, Madrid, España. Electronic address: carlos.lahoz@salud.madrid.org.
authors.forename: C
authors.initials: C
authors.lastname: Lahoz
authors.affiliation: Centro de Salud Fuencarral, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Barrionuevo
authors.affiliation: Centro de Salud Fuencarral, Madrid, España.
authors.forename: T
authors.initials: T
authors.lastname: García-Fernández
authors.affiliation: Centro de Salud Monóvar, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Vicente
authors.affiliation: Unidad de Lípidos y Riesgo Cardiovascular, Hospital Carlos III, Madrid, España.
authors.forename: M F
authors.initials: MF
authors.lastname: García-Iglesias
authors.affiliation: Unidad de Lípidos y Riesgo Cardiovascular, Hospital Carlos III, Madrid, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Mostaza
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease; D018570:Risk Assessment; D012307:Risk Factors
keywords: Ankle-brachial index; Coronary disease.; Enfermedad arterial periférica; Enfermedad coronaria.; Peripheral arterial disease; Índice tobillo-brazo