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The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study.
Arch Intern Med. 2003 Sep 08; 163(16):1939-42.AI

Abstract

BACKGROUND

A low ankle-brachial index (ABI) is associated with an increased risk of death and cardiovascular disease. Limited data exist regarding the relation between a low ABI and stroke. We sought to examine the relation between a low ABI and stroke, coronary heart disease, and death in the elderly.

METHODS

We examined 251 men and 423 women with a mean age of 80 years who had a Framingham Study examination from 1994 to 1995. A low ABI was defined as less than 0.9. Persons were followed up for 4 years for occurrence of stroke or transient ischemic attack, coronary disease, and death. Cox proportional hazards models were used to assess the relation between a low ABI and each outcome after adjusting for age, sex, and prevalent cardiovascular disease.

RESULTS

A low ABI was detected in 20% of our sample. Only 18% of the participants with a low ABI reported claudication symptoms. One third of those with a normal ABI and 55% of those with a low ABI had cardiovascular disease at baseline. Results of multivariable Cox proportional hazards analysis demonstrated a statistically significant increase in the risk of stroke or transient ischemic attack in persons with a low ABI (hazards ratio, 2.0; 95% confidence interval, 1.1-3.7). No significant relation between a low ABI and coronary heart disease (hazards ratio, 1.2; 95% confidence interval, 0.7-2.1) or death (hazards ratio, 1.4; 95% confidence interval, 0.9-2.1) was observed.

CONCLUSIONS

A low ABI is associated with risk of stroke or transient ischemic attack in the elderly. These results need to be confirmed in larger studies.

Authors+Show Affiliations

National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Framingham, MA 01702-5827, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12963567

Citation

Murabito, Joanne M., et al. "The Ankle-brachial Index in the Elderly and Risk of Stroke, Coronary Disease, and Death: the Framingham Study." Archives of Internal Medicine, vol. 163, no. 16, 2003, pp. 1939-42.
Murabito JM, Evans JC, Larson MG, et al. The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study. Arch Intern Med. 2003;163(16):1939-42.
Murabito, J. M., Evans, J. C., Larson, M. G., Nieto, K., Levy, D., & Wilson, P. W. (2003). The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study. Archives of Internal Medicine, 163(16), 1939-42.
Murabito JM, et al. The Ankle-brachial Index in the Elderly and Risk of Stroke, Coronary Disease, and Death: the Framingham Study. Arch Intern Med. 2003 Sep 8;163(16):1939-42. PubMed PMID: 12963567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The ankle-brachial index in the elderly and risk of stroke, coronary disease, and death: the Framingham Study. AU - Murabito,Joanne M, AU - Evans,Jane C, AU - Larson,Martin G, AU - Nieto,Kenneth, AU - Levy,Daniel, AU - Wilson,Peter W F, AU - ,, PY - 2003/9/10/pubmed PY - 2004/2/13/medline PY - 2003/9/10/entrez SP - 1939 EP - 42 JF - Archives of internal medicine JO - Arch Intern Med VL - 163 IS - 16 N2 - BACKGROUND: A low ankle-brachial index (ABI) is associated with an increased risk of death and cardiovascular disease. Limited data exist regarding the relation between a low ABI and stroke. We sought to examine the relation between a low ABI and stroke, coronary heart disease, and death in the elderly. METHODS: We examined 251 men and 423 women with a mean age of 80 years who had a Framingham Study examination from 1994 to 1995. A low ABI was defined as less than 0.9. Persons were followed up for 4 years for occurrence of stroke or transient ischemic attack, coronary disease, and death. Cox proportional hazards models were used to assess the relation between a low ABI and each outcome after adjusting for age, sex, and prevalent cardiovascular disease. RESULTS: A low ABI was detected in 20% of our sample. Only 18% of the participants with a low ABI reported claudication symptoms. One third of those with a normal ABI and 55% of those with a low ABI had cardiovascular disease at baseline. Results of multivariable Cox proportional hazards analysis demonstrated a statistically significant increase in the risk of stroke or transient ischemic attack in persons with a low ABI (hazards ratio, 2.0; 95% confidence interval, 1.1-3.7). No significant relation between a low ABI and coronary heart disease (hazards ratio, 1.2; 95% confidence interval, 0.7-2.1) or death (hazards ratio, 1.4; 95% confidence interval, 0.9-2.1) was observed. CONCLUSIONS: A low ABI is associated with risk of stroke or transient ischemic attack in the elderly. These results need to be confirmed in larger studies. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12963567/The_ankle_brachial_index_in_the_elderly_and_risk_of_stroke_coronary_disease_and_death:_the_Framingham_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/1939 DB - PRIME DP - Unbound Medicine ER -