Disparate effects of ankle-brachial index on mortality in the ‘very old’ and ‘younger old’ populations-the PolSenior survey

Abstract

To assess the relationship between ankle-brachial index (ABI) and up to 10-year mortality in older individuals below and above the age of 80 years. In a multicenter survey of health status in the community dwelling subjects aged 55–59 and 65 + years in Poland, we assessed baseline medical history including risk-factors. We measured ABI, and serum creatinine, cholesterol, NT-proBNP, and interleukin-6 (IL-6) concentrations. We assessed mortality based on public registry. Between 2009 and 2019, 27.3% of 561 participants < 80 years, and 79.4% of 291 participants ≥ 80 years, died (p < 0.001); 67.8, 41.5, and 40.3% in the ABI groups < 0.9, 0.9–1.4, and > 1.4, respectively (p < 0.01). In the unadjusted Cox models, ABI was associated with mortality in the entire group, and < 80 years. In the entire group, analysis adjusted for age and sex showed mortality risk increased by 11% per year, and 50% with male sex. Mortality decreased by 37% per 1 unit ABI increase. In the group of people ≥ 80 years, only age was significantly associated with mortality (p < 0.001). In stepwise regression ABI < 0.9, male sex, active smoking, and NT-proBNP level were associated with risk of death < 80 years. In the ≥ 80 years old, mortality risk was associated with older age, and higher levels of IL-6, but not ABI. The ABI < 0.9 is associated with higher mortality in older people, but not among the oldest-old. In the oldest age group, age is the strongest predictor of death. In this age group, inflammageing is of importance.

Mortality of older persons with and without abnormalities in the physical examination of arterial system

“…ABI < 0.9 is a sign of PAD, 1.4 > ABI ≥ 0.9 is considered normal, while ABI ≥ 1.4 corresponds to stiff arteries. In earlier research, we did not demonstrate 9-year difference in mortality between the 1.4 > ABI ≥ 0.9 and the ABI ≥ 1.4 groups of older persons [ 9 ]. Previously, we demonstrated the age dependent fashion for the relation between ABI and mortality in older persons [ 9 ].…”

“…In earlier research, we did not demonstrate 9-year difference in mortality between the 1.4 > ABI ≥ 0.9 and the ABI ≥ 1.4 groups of older persons [ 9 ]. Previously, we demonstrated the age dependent fashion for the relation between ABI and mortality in older persons [ 9 ]. We also found that the abnormalities during PHEA are prevalent in persons with greater ABI [ 10 ].…”

“…In our study, we pooled together the data of persons with 0.9 ≤ ABI ≤ 1.4 and ABI > 1.4. We did that because in our earlier analyses, the Kaplan–Meier curves for survival in these groups did not differ [ 9 ]. In our group, persons with ABI < 0.9 have higher SBP values than persons with ABI ≥ 0.9.…”

Which plantar region can predict peripheral arterial disease by using laser speckleflowgraphy?

“…Since LSFG shows skin blood flow as a relative value, it is difficult to use the raw value for comparison between individuals. ABI is a simple and effective test, as there are reports that major amputation may be avoided when endovascular therapy improves ABI by 0.15 or more [6] and that mortality rate in ABI < 0.9 increases more than in ABI > 0.9 [7]. To make the ratio like ABI, the measured In setting the ROI, 12 points that were easily discerned anatomically from the body surface were chosen.…”

Relationship Between Medication Adherence and Ankle-Brachial Index Value in Patients With Hypertention

“…In a prospective study in Spain on 5679 patients, 5517 (97.1%) had a normal ABI, while 162 (2.9%) had ABI≥1.4 [22], which is consistent with the results of the present study. A study by Królczyk in Poland on the different effects of ABI on mortality in older patients, 118 participants had a low ABI (13.9%), 662 had a normal ABI (77.7%), and 72 had a high ABI (8.4%) [23].…”