Ankle/Arm Blood Pressure Index

A basic problem facing the clinician who practices primary prevention of coronary heart disease (CHD) through risk factor modification is that, unless the baseline risk is high, relatively large numbers of patients must undergo risk factor modification to prevent CHD events in a relative few.1This is particularly a problem for women 45 to 70 years of age. Since the prevalence of CHD is lower in these women, risk factors are moderately less predictive of future CHD events than they are for men.2For these reasons special emphasis is usually placed on risk stratification (presence of multiple CHD risk factors or evidence of end-organ damage or previous vascular morbid events) to indicate which patients should undergo more aggressive risk factor alteration. Now it appears that a relatively simple office procedure involving measurement of the ankle/arm systolic blood pressure index (AAI), which is known to correlate with the presence