Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group.

Newman, Anne B.; Siscovick, David S.; Manolio, Teri A.; Polak, Joseph F.; Fried, Linda P.; Borhani, Nemat O.; Wolfson, Sidney K.

doi:10.1161/01.cir.88.3.837

Cited by 1,025 publications

(804 citation statements)

References 41 publications

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“…AAI was defined as the lowest ratio of SBP of either the right ankle to the right upper-arm or the left ankle to the right upper-arm. According to previous reports of abnormal AAI associated with preclinical cardiovascular disease, 21 AAI p0.9 in either leg was used to define LEAD.…”

Section: Definition Of Leadmentioning

confidence: 99%

Polymorphisms of angiotensinogen and angiotensin-converting enzyme associated with lower extremity arterial disease in the Health, Aging and Body Composition study

Nicklas

Pahor

et al. 2007

J Hum Hypertens

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The role of renin-angiotensin system (RAS) genes on the risk of lower extremity arterial disease (LEAD) in elderly people remains unclear. We assessed the relationship of genetic polymorphisms in RAS: G-6A, T174M and M235T of the angiotensinogen (AGT) gene, and the angiotensin-converting enzyme insertion/deletion (ACE_I/D) variant to the risk of LEAD in the Health, Aging and Body Composition (Health ABC) Study. This analysis included 1228 black and 1306 white men and women whose age ranged between 70 and 79 years at the study enrollment. LEAD was defined as ankle-arm index (AAI) o0.9. Genotype-phenotype associations were estimated by regression analyses with and without adjustment for established cardiovascular disease (CVD) risk factors. The proportion of LEAD was significantly higher in black (21.1%) than that in white elderly people (10.1%, Po0.0001). The distribution of AGT polymorphisms was also significantly different between black and white participants. There was no statistically significant association between the selected RAS genetic variants and LEAD after adjustment for age, antihypertensive medications, lipid-lowering medication, pack-year smoking, body mass index, low-density lipoprotein cholesterol, and prevalent diabetes and coronary heart disease. However, A-T haplotype of G-6A and M235T interacting with homozygous ACE_II (b ¼ À1.07, P ¼ 0.006) and with ACE inhibitors (b ¼ À1.03, P ¼ 0.01) significantly decreased the risk of LEAD in white but not in black participants after adjustment for the selected CVD risk factors. In conclusion, the study observed a gene-gene and gene-drug interaction for LEAD in the white elderly.

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Section: Definition Of Leadmentioning

confidence: 99%

Polymorphisms of angiotensinogen and angiotensin-converting enzyme associated with lower extremity arterial disease in the Health, Aging and Body Composition study

Nicklas

Pahor

et al. 2007

J Hum Hypertens

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“…It was shown that an ABI of less than 0.90 was 95% sensitive and 99% specific for diagnosing angiographically defined PAD [16]. Individuals with an ABI greater than 1.50 were excluded from this study as it indicated poorly compressible leg arteries [17,18].…”

Section: Assessment Of Peripheral Atherosclerosismentioning

confidence: 99%

Clinically relevant depressive symptoms and peripheral arterial disease in elderly men and women. Results from a large cohort study in Southern China

Wong

Woo

Hong

et al. 2007

Journal of Psychosomatic Research

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Objective-Results from previous epidemiological studies on the relationship between depression and peripheral arterial diseases were mixed. Therefore, a study was conducted to investigate this relationship in a large Chinese elderly sample.Methods-Cross-sectional data from the baseline examination of a large cohort study in Chinese elderly were used in this current study. A stratified convenience sample of 3985 Hong Kong men and women aged 65 to 92 were recruited from the community. Clinically relevant depressive symptoms were assessed by the use of a validated screening instrument for depression: the Chinese version of the Short Form of Geriatric Depression Scale (GDS). Peripheral arterial disease (PAD) was assessed by the ankle-brachial index (ABI), with an index of <0.9 indicating the presence of peripheral arterial disease. Multiple logistic regression was used to compare the presence of PAD in depressed and non-depressed subjects, controlling for confounding variables for the relationship.Results-In the total subject population, more severe peripheral atherosclerosis was associated with a higher prevalence of depressive disorders. The presence of peripheral atherosclerosis was associated with an adjusted odds ratio (OR) of 1.46 (95% confidence interval =1.01 to 2.10) of having clinically relevant depressive symptoms.Conclusion-We showed that depressive symptoms were associated with peripheral atherosclerosis in Asian elderly after adjusting for stroke and cardiovascular diseases. Prospective studies are needed to provide conclusive evidence on the causality on the relationship between peripheral atherosclerosis and depressive symptoms.

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“…A commonly used non-invasive test for peripheral arterial disease is the measurement of systolic blood 12 thus raising several methodological problems, [11][12][13][14][15] which involved: differences in geometry between the two ankle vessels; difference in pressures between the right and left legs; and the decrease in brachial arterial pressure over time which would result in the higher pressure occurring in the leg first measured. [11][12][13][14][15]25,26 For all these reasons, in the present study three measurements were performed on each artery of each limb after 15 min rest and the mean value was taken as the ankle systolic blood pressure.…”

Section: Considerations On the Abi Ratiomentioning

confidence: 99%

“…[11][12][13][14][15] Below the value of 0.94, this ratio is considered to be a clear-cut indicator for arterial occlusion. More recently, the ABI ratio has been recognised to be per se an independent predictor of cardiac risk in subjects with systolic hypertension in the elderly.…”

Section: Introductionmentioning

confidence: 99%

Plasma insulin, plasminogen activator inhibitor, and ankle-brachial systolic blood pressure ratio in overweight hypertensive subjects

et al. 1999

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Background: In hypertensive subjects, the ratio between ankle and brachial systolic blood pressure (ABI) has been shown to be an independent risk factor for cardiovascular diseases, particularly in the elderly. Plasma insulin may be an important interconnecting factor explaining this observation. Purpose: In a population of middle-aged subjects with essential hypertension and moderate overweight, we identified whether the decrease in the ABI ratio was associated with the clinical and biochemical factors involved in resistance to insulin. Patients with diabetes and/or arteriosclerosis obliterans of the lower limbs were excluded from the population. Subjects were or were not on antihypertensive therapy. Result: On the basis of univariate correlations, the ABI ratio was found to be significantly and negatively associated not only with the degree of abdominal fat distri-

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Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group.

Cited by 1,025 publications

References 41 publications

Polymorphisms of angiotensinogen and angiotensin-converting enzyme associated with lower extremity arterial disease in the Health, Aging and Body Composition study

Polymorphisms of angiotensinogen and angiotensin-converting enzyme associated with lower extremity arterial disease in the Health, Aging and Body Composition study

Clinically relevant depressive symptoms and peripheral arterial disease in elderly men and women. Results from a large cohort study in Southern China

Plasma insulin, plasminogen activator inhibitor, and ankle-brachial systolic blood pressure ratio in overweight hypertensive subjects

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