Ankle Brachial Index Predicts Cardiovascular Risk

Patients with a low index have increased rates of cardiovascular events and mortality

TUESDAY, July 8 (HealthDay News) -- When a measurement of the ankle brachial index is combined with the Framingham risk score, it may result in a more accurate predictor of cardiovascular events and mortality, according to a report published in the July 9 issue of the Journal of the American Medical Association.

Gerry Fowkes, Ph.D., of the University of Edinburgh in Edinburgh, U.K., and colleagues from the Ankle Brachial Index Collaboration conducted a meta-analysis of 16 population cohort studies that included 480,325 person-years of follow-up of 24,955 men and 23,339 women.

Compared to patients with a normal ankle brachial index, the researchers found that those with a low ankle brachial index had significantly higher 10-year cardiovascular mortality rates (18.7 percent versus 4.4 percent for men, and 12.6 percent versus 4.1 percent for women). They also found that a low ankle brachial index was associated with doubled rates of 10-year total mortality, cardiovascular mortality, and major coronary events compared with the overall rate in each Framingham risk score category, and calculated that including ankle brachial index measurements would result in reclassification of risk categories and modification of treatment strategies in about 19 percent of men and 36 percent of women.

"The ankle brachial index is potentially a useful tool for prediction of cardiovascular risk," the authors write. "In contrast to measurement of coronary artery calcium and carotid intima media thickness, it has the advantage of ease of use in the primary care physician's office and in community settings. The equipment is inexpensive -- a handheld Doppler costs less than $600. The procedure is simple, taking less than 10 to 15 minutes, and can be performed by a suitably trained nurse or other health care professional."

The study received support from Sanofi-Aventis/BMS. Several of the study authors report financial relationships with the pharmaceutical industry.

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