Use of ankle brachial pressure index to predict cardiovascular events and death : a cohort study

Abstract Objective : To determine whether a low ankle brachial pressure index is associated with an increased risk of cardiovascular events and death, and whether the prediction of such events could be improved by including this index. Design : Cohort study. Setting : 11 practices in Edinburgh, Scotland. Subjects : 1592 men and women aged 55–74 years selected at random from the age-sex registers of 11 general practices and followed up for 5 years. Main outcome measures : Incidence of fatal and non-fatal cardiovascular events and all cause mortality. Results : At baseline 90 (5.7%) of subjects had an ankle brachial pressure index Conclusion : The ankle brachial pressure index is a good predictor of subsequent cardiovascular events, and improves on predictions by conventional risk factors alone. It is simple and accurate and could be included in routine screening of cardiovascular status. Key messages In this study individuals with a low ankle brachial pressure index had an increased risk of fatal and non-fatal cardiovascular events The index was a good predictor of subsequent cardiovascular events, and improved that of conventional risk factors alone The ankle brachial pressure index could be included in routine screening of cardiovascular status Individuals with a low ankle brachial pressure index require additional monitoring, and might benefit from aspirin or other secondary preventive measures