Key result
ABI shows an L-shaped link to CHD in hypertension, with levels ≤ 1.07 tied to ~73% lower odds.
Why the study?
Although an ankle-brachial index of 0.9 or less correlates with cardiovascular events including coronary heart disease, the dose-response relationship between ABI and CHD in hypertensive populations remained unclear.
Does ankle-brachial index level associate with the prevalence of coronary heart disease in Chinese adults with hypertension?
Cross-Sectional (n=10,906)
Does ankle-brachial index level associate with the prevalence of coronary heart disease in Chinese adults with hypertension?
Effect estimate: OR 0.75 (95% CI 0.33-1.71)
In Chinese adults with hypertension, ankle-brachial index exhibits a nonlinear, L-shaped association with coronary heart disease prevalence, with an inflection point at 1.07, below which lower ABI is associated with higher CHD risk.
Does not support routine ABI use for CHD risk stratification in hypertension; leaves open prospective validation of the L-shaped threshold.
BACKGROUND: Prior research has established that an ankle-brachial index (ABI) ≤ 0.9 is positively correlated with cardiovascular events, including coronary heart disease (CHD). The present study aimed to elucidate the dose-response relationship between ABI and CHD within a hypertensive population. METHODS: We conducted a cross-sectional analysis involving 10,900 hypertensive patients, with CHD as the primary outcome. A generalized additive model (GAM) and fitted smoothing curve were employed to assess linearity and delineate the dose-response association between ABI and CHD. RESULTS: The cohort had a mean (SD) age of 68.3 (9.25) years, with 5129 (47.06%) being male. CHD was present in 552 (5.06%) participants. The fully adjusted odds ratio (OR) for CHD associated with ABI levels was 0.75 (95%CI 0.33-1.71). An L-shaped relationship between ABI and CHD was identified, with an inflection point at 1.07. Below this threshold, ABI showed a negative correlation with CHD (OR: 0.27; 95%CI 0.08-0.84), whereas above it, the association was not significant (OR: 3.08; 95%CI 0.60-15.80). CONCLUSIONS: In Chinese adults with hypertension, ABI exhibits a nonlinear, L-shaped association with CHD, with the inflection point at 1.07.
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Zhou et al. (2025) conducted a cross-sectional in Hypertension (n=10,906). Ankle-brachial index (ABI) was evaluated on Coronary heart disease (CHD) prevalence (OR 0.75, 95% CI 0.33-1.71). In Chinese adults with hypertension, ankle-brachial index exhibited a nonlinear, L-shaped association with coronary heart disease, with a significant negative correlation observed only at ABI levels ≤ 1.07 (OR 0.27).
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