Key result
The modified ankle-brachial index definition detected peripheral arterial disease in 32% of elderly hypertensive patients compared to 18% using the traditional definition.
Why the study?
Does a modified ABI definition identify more hypertensive elderly patients at high risk for PAD compared to the traditional definition?
Cross-Sectional (n=65)
Does a modified ABI definition identify more hypertensive elderly patients at high risk for PAD compared to the traditional definition?
Absolute Event Rate: 32% vs 18%
A modified ABI calculation using the lower ankle pressure identifies more elderly hypertensive patients at high cardiovascular risk compared to the traditional method.
May identify more elderly hypertensives at PAD risk; leaves open whether modified ABI improves risk stratification or outcomes.
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.
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Monteiro et al. (2012) conducted a cross-sectional in Hypertension and Peripheral Arterial Disease (n=65). Modified definition of ankle-brachial index (using lower ankle pressure) vs. Traditional definition of ankle-brachial index was evaluated on Presence of peripheral arterial disease (PAD). The modified ankle-brachial index definition detected peripheral arterial disease in 32% of elderly hypertensive patients compared to 18% using the traditional definition.
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