Objective: Despite its screening interest, the ankle-brachial pressure index (ABPI) remains uncommon in general practice, because it needs training and specific devices as Doppler. Easier methods such as the use of automated oscillometric devices may facilitate the peripheral arterial diseases (PADs) screening. We wanted to assess the reliability of the automated oscillometric measurement of the ABPI, compared with the gold standard Doppler ultrasound measurement. Patients and Method: In 287 patients aged 65 years or older without diagnosed PAD, we performed ABPI measurements with oscillometric and Doppler devices. Reproducibility was assessed by the intraclass correlation coefficient of agreement (R) and the Bland and Altman method. Results: The intermethod reliability was bad (R = .346, 95% CI = (0.268-0.420)), with a large confidence interval of the individual differences between the 2 methods: 95% CI = (—0.183-0.346). Conclusion: Automatic oscillometric devices cannot be recommended as reliable methods for ABPI measurement.
Yusuf S., Reddy S., Ounpuu S., Anand S.Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746-2753.
2.
Yusuf S., Reddy S., Ounpuu S., Anand S.Global burden of cardiovascular diseases: part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies . Circulation. 2001;104(23):2855-2864.
3.
Pasternak RC , Criqui MH, Benjamin EJ, et al. AHA conference proceedings. Atherosclerotic Vascular Disease Conference. Writing group I: epidemiology. Circulation. 2004;109(21):2605-2612.
4.
Newman AB, Siscovick DS, Manolio TA, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Circulation. 1993;88(3):837-845.
5.
Abbott RD, Rodriguez BL, Petrovitch H., et al. Ankle-brachial blood pressure in elderly men and the risk of stroke: the Honolulu Heart Program. J Clin Epidemiol. 2001;54(10):973-978.
6.
Aboyans V., Criqui MHCan we improve the cardiovascular risk prediction beyond risk equations in the physician’s office? J Clin Epidemiol. 2006;59(6):547-558.
7.
Doobay AV, Anand SSSensitivity and specificity of the ankle-brachial index to predict future cardiovascular outcomes: a systematic review. Arterioscler Thromb Vasc Biol. 2005; 25(7):1463-1469.
8.
Belch JJF , Topol EJ, Agnelli G., et al. Critical issues in peripheral arterial disease detection and management. A call to action. Arch Intern Med. 2003;163(8):884-892.
9.
AHA Prevention Conference V, writing group III.Behond secondary prevention: identifying the high-risk patient for primary prevention. Non-invasive tests of artherosclerotic burden. Circulation. 2000;286(101):1317-1324.
10.
Norgren L., Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33(suppl 1):S1-S75.
11.
McDermott MM , Criqui MH, Liu K., et al. Lower ankle/ brachial index, as calculated by averaging the dorsalis pedis and posterior tibial arterial pressures, and association with leg functioning in peripheral arterial disease. J Vasc Surg. 200; 32(6):1164-1171.
12.
Lundin M., Wiksten JP, Peräkylä T., et al. Distal pulse palpation: is it reliable? World J Surg. 1999;23(3):252-255.
13.
Criqui MH, Fronek A., Klauber MR, Barrett-Connor E., Gabriel S.The sensitivity, specificity, and predictive value of traditional clinical evaluation of peripheral arterial disease; results from non invasive testing in a defined population. Circulation. 1985 ;71(3): 516-522.
14.
Hirsch AT, Haskal ZJ, Hertzer NR, et al. Guidelines for the management of patients with peripheral arterial disease: a collaborative report ACC/AHA 2005. http://content.onlinejacc.org/cgi/content/full/47/6/e1. Accessed July 2009.
15.
Beckman JA, Higgins CO, Gerhard-Herman M.Automated Oscillometric Determination of the Ankle-Brachial Index provides accuracy necessary for office practice. Hypertension . 2006;47(1):35-38.
16.
Mohler ER, Treat-Jacobson D., Reilly MP, et al. Utility and barriers to performance of the ankle-brachial index in primary care practice. Vasc Med. 2004;9(4):253-260.
17.
Simon A., Papoz L., Ponton A., et al. Feasibility and reliability of ankle-arm blood pressure index in preventive medicine. Angiology. 2000;51(6):463-469.
18.
Pessenhofer H.Single cuff comparison of two methods for indirect measurement of arterial blood pressure: standard auscultatory methods versus automatic oscillometric method. Basic Res Cariol. 1986;81(1):101-109.
19.
Imai Y., Abe K., Saski S., et al. Clinical evaluation of semiautomatic and automatic devices for home blood pressure measurement: comparison between cuff-oscillometric and microphone methods. J Hypertens. 1989;7(12):983-990.
20.
Adiseshiah M., Cross FW, Belsham PAAnkle blood pressure measured by automatic oscillotonometry: a comparison with Doppler pressure measurements. Ann R Coll Surg Engl. 1987 ; 69(6):271-273.
21.
Lee BY, Campbell JS, Berkowitz P.The correlation of ankle oscillometric blood pressures and segmental pulse volumes to Doppler systolic pressures in arterial acclusive disease . J Vasc Surg. 1996;23(1):116-122.
22.
Ramanathan A., Conaghan PJ, Jenkinson AD, Bishop CRComparison of ankle-brachial pressure index measurements using an automated oscillometric device with the standard doppler ultrasound technique. ANZ J Surg. 2003;73(3):105-108.
23.
Benchimol A. , Bernard V., Pillois X., Hong NT, Benchimol D., Bonnet J.Validation of a new method of detecting peripheral artery disease by determination of ankle-brachial index using an automatic blood pressure device. Angiology . 2004;55(2):127-134.
24.
Pan CR, Staessen JA, Li Y., Wang JGComparison of three measures of the ankle-brachial blood pressure index in a general population. Hypertension Res. 2007 ;30:555-561.
25.
MacDonald E. , Froggatt P., Lawrence G., Blair S.Are automated blood pressure monitors accurate enough to calculate the ankle brachial pressure index? J Clin Monit Comput. 2008;22(5): 381-384.
26.
MacDougall AM, Tandon V., Wilson MP, Wilson TWOscillometric measurement of ankle-brachial index. Can J Cardiol. 2008;24(1):49-51.
27.
Diehm N., Dick F., Czuprin C., Lawall H., Baumgartner I., Diehm C.Oscillometric measurement of ankle-brachial index in patients with suspected peripheral disease: comparison with Doppler method. Swiss Med Wkly.2009;139(25-26):357-363.
28.
Altman DG, Bland JMMeasurement in medicine: the analysis of method comparison studies . Statistician. 1983;32:307-317.
29.
Bland JM, Altman DGStatistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-310.
30.
Bartko JJThe intraclass correlation coefficient as a measure of reliability . Psychological Reports. 1966;19(1):3-11.
31.
Anastas ZM, Jimerson E., Garolis S.Comparison of noninvasive blood pressure measurements in patients with atrial fibrillation. J Cardiovasc Nurs. 2008;23(6):519-524.
32.
Automatic blood pressure measuring devices suitable for use in the clinic and also at home for self-monitoring. http://www.bhsoc.org/bp_monitors/automatic.stm. Accessed July 2009.
33.
Topouchian JA, El Assaad MA, Orobinskaia LV, El Feghali RN, Asmar RGValidation of two automatic devices for self-measurement of blood pressure according to the international protocol of the european society of hypertension: the Omron M6 (HEM-7001-E) and the Omron R7 (HEM 637-IT) . Blood Press Monit. 2006;11(3):165-171.
34.
Carter SAIndirect systolic pressures and pulse waves in arterial acclusive disease of the lower extremities. Circulation. 1968 ; 37(4):624-637.
35.
Hirsch AT, Halverson SL, Treat-Jacobson D., et al. Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA. 2001;286(11):1317-1324.
36.
Rouquette A. , Tomas J., Leborgne C., et al. Intérêt du calcul de l’index de pression systolique à la cheville (IPSC) par tensiomètre automatique dans le dépistage de l’artériopathie oblitérante des membres inférieurs (AOMI) et analyse des facteurs de risque. Angéiologie. 2007; 59(2):18-22.
37.
Aboyans V., Lacroix P., Lebourdon A., Preux PM, Ferrières J., Laskar M.The intra- and interobserver variability of ankle-arm blood pressure index according to its mode of calculation. J Clin Epidemiol . 2003;56(3):215-220.
38.
Aboyans V., Lacroix P., Doucet S., Preux PM, Criqui MH, Laskar M.Diagnosis of peripheral arterial disease in general practice: can the ankle-brachial index be measured either by pulse palpation or an automatic blood pressure device. Int J Clin Pract. 2008 ;62(7):1001-1007.
