Abstract
Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle–brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9<ABI<1.3). Biochemical parameters, clinical characteristics and 10-year hard coronary heart disease (HCHD) Framingham Risk Score (FRS) were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87±6.11 vs. 3.98±2.90%, P<0.001). There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01). The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05), and it was higher in participants with HCHD FRS≥6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05). Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS≥6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05). BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China.
Highlights
Ankle-brachial index (ABI) is a simple and noninvasive method which is widely used to identify peripheral artery disease
The level of highsensitivity C-reactive protein (hsCRP) was significantly higher in high ABI group than normal ABI group (P,0.01). 65.6% of participants in the high ABI group had a history of smoking, while only 35.4% of participants in the normal ABI group had a history of smoking
The prevalence of ischemic stroke was compared between these four groups and the results showed that the prevalence of ischemic stroke in the group with high ABI and hard coronary heart disease (HCHD) Framingham Risk Score (FRS)$6% was higher than the group with normal ABI and HCHD FRS,6% (26.7% vs. 4.1%, P,0.05, Figure 2C), which suggested that high ABI combined with high HCHD FRS indicated elevated risk of ischemic stroke in the general population
Summary
Ankle-brachial index (ABI) is a simple and noninvasive method which is widely used to identify peripheral artery disease. Our previous study showed that patients with more metabolic risk factors had higher risk of high ABI [3], but it is controversial that whether high ABI will increase the risk of cardiovascular and cerebrovascular events in the general population. Other study evidence demonstrated that high ABI was independently associated with incident CVD events defined as coronary disease, stroke, or other atherosclerotic CVD death [5,6]. A recent study found that coronary artery calcium (CAC) volume was positively and independently associated with CVD risk. For high ABI usually indicated the existence of arterial calcification, the relationship between high ABI and the risk of cardiovascular and cerebrovascular events in the general population needs to be further explored
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