Key result
Second-quartile ABPI is linked to ~11% lower all-cause mortality in adults without arterial stiffness.
Why the study?
The relationship between ankle-brachial blood pressure index and all-cause or cardiovascular mortality in adults without arterial stiffness was unclear.
Does lower ABPI increase the risk of all-cause and cardiovascular mortality in adults without arterial stiffness?
Cohort (n=6,784)
Yes
Does lower ABPI increase the risk of all-cause and cardiovascular mortality in adults without arterial stiffness?
Hazard Ratio: 0.89 (95% CI 0.79–0.98)
p-value: p=0.036
In adults without arterial stiffness, lower ABPI values within the normal range are independently associated with an increased risk of all-cause and cardiovascular mortality.
ABPI may refine mortality risk stratification without arterial stiffness; leaves open causal effects and needs prospective validation.
PURPOSE: To explore the relationship between ankle-brachial blood pressure index (ABPI) and all-cause or cardiovascular mortality in adults without arterial stiffness. METHODS: A total of 6784 participants without arterial stiffness were enrolled from National Health and Nutrition Examination Survey 1999-2004. The hazard ratio (HR) and 95% confidence interval (CI) of ABPI associating with the risk of all-cause and cardiovascular mortality was calculated by Cox proportional regression models adjusted for demographic and traditional risk factors. Dose-response relationship was explored with restricted cubic spines. RESULTS: After an average follow-up of 12.1 years, 1844 all-cause deaths and 299 cardiovascular deaths occurred. Compared with the lowest ABPI quartile, the second quartile was associated with the lowest risk of all-cause mortality (HR 0.89, 95%CI 0.79-0.98; p = 0.036) and cardiovascular mortality (HR 0.75, 95%CI 0.56-0.98; p = 0.048). Besides, dose-response analysis revealed that ABPI was nonlinearly correlated to all-cause mortality (p for nonlinearity < 0.001) and linearly correlated to cardiovascular mortality (p for nonlinearity = 0.459). CONCLUSIONS: The relationship between ABPI and all-cause and cardiovascular mortality followed a L-shape curve. A lower ABPI was independently associated with an increased risk of all-cause and cardiovascular mortality in adults without arterial stiffness.
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Meng et al. (2023) conducted a cohort in Adults without arterial stiffness (n=6,784). Ankle-brachial blood pressure index (ABPI) vs. Lowest ABPI quartile was evaluated on All-cause mortality (HR 0.89, 95% CI 0.79-0.98, p=0.036). In adults without arterial stiffness, an ankle-brachial blood pressure index in the second quartile was associated with a lower risk of all-cause mortality (HR 0.89) compared to the lowest quartile.
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