ANKLE/ARM PRESSURE INDEX IN ASYMPTOMATIC MIDDLE-AGED MALES - AN INDEPENDENT PREDICTOR OF 10-YEAR CORONARY HEART-DISEASE MORTALITY

Purpose of the study: to evaluate the predictive power of a reduced ankle/brachial pressure index (ABPI) (less than or equal to.90) in an asymptomatic middle-aged male working population free of coronary heart disease. Materials and Methods: 2023 subjects forty to fifty-five years old were screened at their work place. Standard techniques were used, Blood was drawn in the fasting state. Ankle and brachial blood pressures were measured by Doppler signals and all measures were done by one observer, duly trained in epidemiologic methodology. Results: in univariate analysis, an ABPI less than or equal to.90 was significantly associated with age, total serum cholesterol, body mass index, smoking, and awareness of diabetes. In multivariate analysis, it was associated with awareness of diabetes, age, Ln triglycerides (P=.073), and smoking (P=.088). Relative risks for reduced versus normal ABPI are 2.77 (P=.010), 4.16 (P=.011) and 4.97 (P=.006) for ten-year all causes, cardiovascular, and coronary mortality, respectively. In a multiple logistic regression analysis, the following variables were significant independent predictors of coronary mortality: smoking (odds ratio [OR] =4.84), reduced ABPI (OR=3.63), and low density lipoprotein cholesterol (OR for 1 SD=1.69). Reduced ABPI is also an independent predictor of cardiovascular mortality. Conclusion: a reduced ABPI is an independent risk factor for coronary and cardiovascular mortality in asymptomatic middle-aged Belgian males.