A Low Ankle Brachial Index is Associated with an Increased Risk of Cardiovascular Disease: The Hisayama Study

• Published in: Journal of Atherosclerosis and Thrombosis 2014/09/24, Vol.21(9), pp.966-973
• Main Authors: Kojima, Iwao, Ninomiya, Toshiharu, Hata, Jun, Fukuhara, Masayo, Hirakawa, Yoichiro, Mukai, Naoko, Yoshida, Daigo, Kitazono, Takanari, Kiyohara, Yutaka
• Format: Article
• Language: English
• Subjects: Ankle Brachial Index; Cardiovascular disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - pathology; Epidemiology; Female; Follow-Up Studies; Humans; Incidence; Japan - epidemiology; Male; Middle Aged; Peripheral artery disease; Prognosis; Prospective Studies; Prospective study; Risk Factors; Survival Rate
• ISSN: 1340-3478; 1880-3873
• DOI: 10.5551/jat.22608

Aim: Peripheral artery disease (PAD), defined as a decreased ankle brachial index (ABI), is a risk factor for cardiovascular disease; however, few studies have assessed the relationship between a low ABI and cardiovascular risks in Asian populations. We herein examined the relationship between the ABI and the development of cardiovascular disease in a Japanese community. Methods: A total of 2,954community-dwelling Japanese individuals without prior cardiovascular disease ≥ 40years of age were followed up for an average of 7.1years. The subjects’ ABIs were categorized into the three groups: low (≤0.90), borderline (0.91-0.99) and normal (1.00-1.40). We estimated the relationship between the ABI and cardiovascular risk using a Cox proportional hazards model. Results: During the follow-up period, 134subjects experienced cardiovascular events. The incidence of cardiovascular disease across the ABI values was significantly different (p＜0.001). After adjusting for confounding factors, namely age, sex, systolic blood pressure, use of anti-hypertensive drugs, diabetes, total cholesterol, high-density lipoprotein cholesterol, obesity, smoking, alcohol intake and regular exercise, individuals with a low ABI were at 2.40-fold (95% confidence interval [CI] 1.14-5.06) greater risk of cardiovascular disease and 4.13-fold (95% CI 1.62-10.55) greater risk of coronary heart disease. Conclusions: Our findings suggest that individuals with an ABI of ≤ 0.90 have an increased risk of cardiovascular events, independent from traditional risk factors, in the general Japanese population.