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Peripheral artery disease and hypertension: the relation between ankle–brachial index and mortality

Journal of Human Hypertension volume 21, pages 762–765 (2007)Cite this article

Individuals with peripheral arterial disease (PAD), characterized by atherosclerosis of peripheral arteries, particularly those involving the lower extremities are at an increased risk of adverse cardiovascular events and consequent morbidity and mortality.1 Indeed, the presence of PAD is in itself evidence of widespread atherosclerosis in other vascular territories, with further evidence that it is also a predictor of future cardiovascular outcomes such as stroke, myocardial infarction and death. It would be logical to infer that the risk factors associated with the development of PAD would also have a significant role in the pathogenesis of cardiovascular disease (CVD) and its complications.

The ankle–brachial index (ABI), a simple and non-invasive test that can be performed in the office/clinic setting, is used in the diagnosis of PAD of the extremities in symptomatic patients and to assess vascular risk in those without symptoms. The ABI is defined as ‘the ratio of the ankle to brachial systolic blood pressure (SBP), with values <0.90 suggestive of flow-limiting arterial disease of the limb.’ A systematic review1 of studies looking at the sensitivity and specificity of ABI to predict future cardiovascular outcomes found the ABI to have a high specificity, but a low sensitivity to predict future cardiovascular events in nine studies, that is, a low ABI could ‘rule in’ a high-risk patient, but a normal ABI could not ‘rule out’ a high risk one.1

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  1. University Department of Medicine, City Hospital, Birmingham, UK

    V J Karthikeyan & G Y H Lip

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Correspondence to G Y H Lip.

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Karthikeyan, V., Lip, G. Peripheral artery disease and hypertension: the relation between ankle–brachial index and mortality. J Hum Hypertens 21, 762–765 (2007). https://doi.org/10.1038/sj.jhh.1002219

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