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Risk factors related to low ankle-brachial index measured by traditional and modified definition in hypertensive elderly patients.

Monteiro R, Marto R, Neves MF - Int J Hypertens (2012)

Bottom Line: Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions.Smoking and LDL-cholesterol were associated with low ABI only by the modified definition.In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, State University of Rio de Janeiro, Avenida 28 de Setembro 77, Sala 329, 20551-030 Rio de Janeiro, RJ, Brazil.

ABSTRACT
Peripheral arterial disease (PAD) increases with age and ankle-brachial index (ABI) ≤ 0.9 is a noninvasive marker of PAD. The purpose of this study was to identify risk factors related to a low ABI in the elderly using two different methods of ABI calculation (traditional and modified definition using lower instead of higher ankle pressure). A cross-sectional study was carried out with 65 hypertensive patients aged 65 years or older. PAD was present in 18% of individuals by current ABI definition and in 32% by modified method. Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions. Smoking and LDL-cholesterol were associated with low ABI only by the modified definition. Low ABI by the modified definition detected 9 new cases of PAD but cardiovascular risk had not been considered high in 3 patients when calculated by FRS. In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

No MeSH data available.


Related in: MedlinePlus

Correlation of ankle-brachial index (ABI) with fasting glucose (a) and with pulse pressure (b).
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fig1: Correlation of ankle-brachial index (ABI) with fasting glucose (a) and with pulse pressure (b).

Mentions: The mean age of our sample (n = 65) was 73 years, ranging from 65 to 90 years, and mostly composed by women (76%) and white (62%) subjects (Table 1). A low ABI (≤0.9) occurred in 12 (18%) subjects. There was a significantly higher prevalence of diabetes mellitus, cardiovascular disease, metabolic syndrome, and elevated cardiovascular risk by FRS in the group with low ABI (Table 2). Considering all patients in both groups, there was a moderate inverse correlation between fasting glucose and ABI (Figure 1(a)). Among criteria that defined metabolic syndrome, the most important factor in these older hypertensive patients was fasting glucose (Figure 2).


Risk factors related to low ankle-brachial index measured by traditional and modified definition in hypertensive elderly patients.

Monteiro R, Marto R, Neves MF - Int J Hypertens (2012)

Correlation of ankle-brachial index (ABI) with fasting glucose (a) and with pulse pressure (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3376503&req=5

fig1: Correlation of ankle-brachial index (ABI) with fasting glucose (a) and with pulse pressure (b).
Mentions: The mean age of our sample (n = 65) was 73 years, ranging from 65 to 90 years, and mostly composed by women (76%) and white (62%) subjects (Table 1). A low ABI (≤0.9) occurred in 12 (18%) subjects. There was a significantly higher prevalence of diabetes mellitus, cardiovascular disease, metabolic syndrome, and elevated cardiovascular risk by FRS in the group with low ABI (Table 2). Considering all patients in both groups, there was a moderate inverse correlation between fasting glucose and ABI (Figure 1(a)). Among criteria that defined metabolic syndrome, the most important factor in these older hypertensive patients was fasting glucose (Figure 2).

Bottom Line: Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions.Smoking and LDL-cholesterol were associated with low ABI only by the modified definition.In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, State University of Rio de Janeiro, Avenida 28 de Setembro 77, Sala 329, 20551-030 Rio de Janeiro, RJ, Brazil.

ABSTRACT
Peripheral arterial disease (PAD) increases with age and ankle-brachial index (ABI) ≤ 0.9 is a noninvasive marker of PAD. The purpose of this study was to identify risk factors related to a low ABI in the elderly using two different methods of ABI calculation (traditional and modified definition using lower instead of higher ankle pressure). A cross-sectional study was carried out with 65 hypertensive patients aged 65 years or older. PAD was present in 18% of individuals by current ABI definition and in 32% by modified method. Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions. Smoking and LDL-cholesterol were associated with low ABI only by the modified definition. Low ABI by the modified definition detected 9 new cases of PAD but cardiovascular risk had not been considered high in 3 patients when calculated by FRS. In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.

No MeSH data available.


Related in: MedlinePlus