We tested the hypothesis that the Ankle-Brachial Index (ABI) in patients without peripheral arterial disease ([PAD] ABI > 1.0) is an indicator of arterial stiffness. Fifty-five patients had measurement of carotid pulse wave contour, pulse wave velocity (PWV), and ABI. Vascular stiffness as assessed by augmentation index (AIx) showed a significant (P = .002) inverse correlation with ABI. Dichotomizing ABI into groups above and below the median showed that persons with a lower ABI, >1.0 to 1.5 (n = 27) had a significantly (P < .01) higher AIx than those with a higher ABI > 1.5 (n = 28). In contrast, vascular stiffness assessed by brachial-ankle or carotid femoral PWV did not correlate with ABI. In summary, ABI is an indicator of arterial stiffness assessed by AIx. Vascular changes detected by AIx are not the same as those detected by PWV. Assessment of ABI may have utility in cardiovascular risk assessment in patients without PAD.
Mattace-RasoFUSvan der CammenTJMHofmanA. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation. 2006;113(5):657–663.
2.
MitchellGFHwangS-JVasanRS. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010;121(4):505–511.
3.
ChirinosJAZambranoJPChakkoS. Aortic pressure augmentation predicts adverse cardiovascular events in patients with established coronary artery disease. Hypertension. 2005;45(5):980–985.
4.
CovicAMardareNGusbeth-TatomirPPrisadaOSascauRGoldsmithDJA.Arterial wave reflections and mortality in haemodialysis patients–only relevant in elderly, cardiovascularly compromised?Nephrol Dial Transplant. 2006;21(10):2859–2866.
5.
WeberTAuerJO’RourkeMFKvasELassnigEBerentREberB.Arterial stiffness, wave reflections, and the risk of coronary artery disease. Circulation. 2004;109(2):184–189.
6.
WangK-LChengH-MSungS-H. Wave reflection and arterial stiffness in the prediction of 15-year all-cause and cardiovascular mortalities: a community-based study. Hypertension. 2010;55(3):799–805.
7.
NewmanABSiscovickDSManolioTA. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group. Circulation. 1993;88(3):837–845.
8.
LengGCFowkesFGLeeAJDunbarJHousleyERuckleyCV.Use of ankle brachial pressure index to predict cardiovascular events and death: a cohort study. BMJ. 1996;313(7070):1440–1444.
9.
HealdCLFowkesFGRMurrayGDPriceJF.Ankle Brachial Index C. Risk of mortality and cardiovascular disease associated with the ankle-brachial index: systematic review. Atherosclerosis. 2006;189(1):61–69.
10.
FowkesFGRMurrayGDButcherI. Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA. 2008;300(2):197–208.
11.
van PopeleNMGrobbeeDEBotsML. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke. 2001;32(2):454–460.
12.
KhandanpourNArmonMPJenningsBClarkAMeyerFJ.The association between ankle brachial pressure index and pulse wave velocity: clinical implication of pulse wave velocity. Angiology. 2009;60(6):732–738.
13.
EliakimMSapoznikovDWeinmanJ.Pulse wave velocity in healthy subjects and in patients with various disease states. Am Heart J. 1971;82(4):448–457.
14.
O’RourkeMFNicholsWW.Aortic diameter, aortic stiffness, and wave reflection increase with age and isolated systolic hypertension. Hypertension. 2005;45(4):652–658.
15.
DaviesJEBaksiJFrancisDP. The arterial reservoir pressure increases with aging and is the major determinant of the aortic augmentation index. Am J Physiol Heart Circul Physiol. 2010;298(2):H580–H586.
16.
McEnieryCMMcDonnellBJSoA. Aortic calcification is associated with aortic stiffness and isolated systolic hypertension in healthy individuals. Hypertension. 2009;53(3): 524–531.
17.
RabkinSW.Endothelin but not angiotensin II may mediate hypertension-induced coronary vascular calcification in chronic kidney disease. Int J Nephrol. 2011doi:10.4061/2011/516237.
18.
YamashinaATomiyamaHTakedaK. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res Clin Exper. 2002;25(3):359–364.
19.
FukudaDYoshiyamaMShimadaK. Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease. Heart. 2006;92(6):759–762.
20.
KojiYTomiyamaHIchihashiH. Comparison of ankle-brachial pressure index and pulse wave velocity as markers of the presence of coronary artery disease in subjects with a high risk of atherosclerotic cardiovascular disease. Am J Cardiol. 2004;94(7):868–872.
21.
SugawaraJHayashiKYokoiT. Brachial-ankle pulse wave velocity: an index of central arterial stiffness?J Hum Hypertens. 2005;19(5):401–406.
22.
TanakaHMunakataMKawanoY. Comparison between carotid-femoral and brachial-ankle pulse wave velocity as measures of arterial stiffness. J. Hypertension. 2009;27(10):2022–2027.
23.
YasminBrown MJ.Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness. QJM. 1999;92(10):595–600.
24.
DaviesJIStruthersAD.Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses. J Hypertension. 2003;21(3):463–472.
25.
KellyRPMillasseauSCRitterJMChowienczykPJ.Vasoactive drugs influence aortic augmentation index independently of pulse-wave velocity in healthy men. Hypertension. 2001;37(6):1429–1433.
26.
ZiemanSJMelenovskyVKassDA.Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vas Biol. 2005;25(5):932–943.
27.
TarumiTSugawaraJTanakaH.Association between ankle blood pressure and central arterial wave reflection. J Hum Hyperts. 2010;Epub ahead of print. DOI:10.1038/jhh.2010.100
28.
KhaleghiMKulloIJ.Aortic augmentation index is associated with the ankle-brachial index: a community-based study. Atherosclerosis. 2007;195(2):248–253.
29.
ResnickHELindsayRSMcDermottMM. Relationship of high and low ankle brachial index to all-cause and cardiovascular disease mortality. Circulation. 2004;109(6):733–739.
30.
BeckmanJAHigginsCOGerhard-HermanM.Automated oscillometric determination of the ankle-brachial index provides accuracy necessary for office practice. Hypertension. 2006;47(1):35–38.
