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ATHENS, GREECE. The ratio of the systolic blood pressure measured at the ankle and in the arm (brachial
pressure) is used as an indication of the presence of peripheral arterial diseases such as intermittent
claudication. Researchers at the Alexandra University Hospital now report that the ankle-brachial pressure
index (ABI) can also be used to determine the extent of coronary atherosclerosis. The study included 165
patients (41 women and 124 men between the ages of 50 and 70 years) scheduled for elective coronary
angiography.
The study participants underwent ultrasound imaging as well as angiography and also had a fasting blood
sample drawn. In addition, all participants had their blood pressure measured in the supine position (after
five minutes of rest) at the ankle and in the arm. The researchers found a significant correlation between
ABI and smoking and diabetes. Body mass index, hypertension, cholesterol, triglycerides, HDL and LDL
cholesterol, uric acid, fibrinogen, and insulin level were not significantly related to ABI. ABI was inversely
related to the extent of narrowing of coronary arteries (at the carotid bifurcation - a strong marker of coronary
artery disease). A low ABI (less than 0.9) was also found to correlate well with an increased severity of
arterial blockage. The study participants were followed for 14 months during which time six died from
cardiovascular causes, five experienced a non-fatal heart attack, 15 were hospitalized with unstable angina,
30 underwent bypass surgery, and 29 underwent angioplasty. The researchers noted that the rate of
adverse events among the patients with an ABI less than 0.9 was 27 per cent as compared to only 10 per
cent among the patients with an ABI greater than 0.9. The researchers conclude that a low ABI is an
indicator of atherosclerosis and a risk factor for cardiovascular events.
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