TY - JOUR
T1 - The Relationship Between High Pulse Pressure and Low Ankle-Brachial Index. Potential Utility in Screening for Peripheral Artery Disease in Population-Based Studies
AU - Del Brutto, Oscar H.
AU - Mera, Robertino M.
AU - Sedler, Mark J.
AU - Gruen, Jadry A.
AU - Phelan, Kelsie J.
AU - Cusick, Elizabeth H.
AU - Zambrano, Mauricio
AU - Brown, David L.
N1 - Publisher Copyright:
© 2015, Springer International Publishing Switzerland.
PY - 2015/9/10
Y1 - 2015/9/10
N2 - Introduction: The ankle-brachial index (ABI) is a reliable screening procedure for peripheral artery disease detection. However, ABI testing is time-consuming and requires trained personnel, which may preclude its routine use in population-based surveys. Preliminary data suggest a relationship between ABI values and pulse pressure (PP) levels. Aim: To assess whether PP calculation might help to detect persons who need ABI screening in population-based studies. Methods: All Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo ABI testing. Non-consented persons and those with ABI ≥1.4 were excluded. Using generalized linear and logistic regression models adjusted for demographics and cardiovascular risk factors, as well as receiver operator characteristics curve analysis, we evaluated the association between PP values and ABI, as well as the reliability of PP to identify candidates for ABI testing. Results: Out of 239 participants (mean age 70 ± 8 years, 62 % women), 46 (19 %) had an ABI ≤0.9 and 136 (57 %) had PP >65 mmHg, with a negative relationship between them (R = −0.386, p < 0.0001). A PP >65 mmHg was associated with an ABI ≤ 0.9 in the logistic regression model (OR 3.46, 95 % CI 1.07–11.2, p = 0.038). Continuous PP levels also correlated negatively with ABI (β −0.0014, 95 % CI −0.0024 to −0.0004, p = 0.005). The sensitivity of a PP >65 mmHg to predict a low ABI was 85 %, and the specificity was 50 %. In contrast, the sensitivity of blood pressure ≥140/90 mmHg was 27 % and the specificity was 10 %. The area under the curve for the predictive value of a PP >65 mmHg was 0.673 (95 % CI 0.609–0.736), and that of a blood pressure ≥140/90 mmHg was 0.371 (95 % CI 0.30–0.443), with a significant difference between them (p < 0.0001). Conclusions: PP calculation may be a simple tool to detect candidates for ABI testing in population-based studies.
AB - Introduction: The ankle-brachial index (ABI) is a reliable screening procedure for peripheral artery disease detection. However, ABI testing is time-consuming and requires trained personnel, which may preclude its routine use in population-based surveys. Preliminary data suggest a relationship between ABI values and pulse pressure (PP) levels. Aim: To assess whether PP calculation might help to detect persons who need ABI screening in population-based studies. Methods: All Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo ABI testing. Non-consented persons and those with ABI ≥1.4 were excluded. Using generalized linear and logistic regression models adjusted for demographics and cardiovascular risk factors, as well as receiver operator characteristics curve analysis, we evaluated the association between PP values and ABI, as well as the reliability of PP to identify candidates for ABI testing. Results: Out of 239 participants (mean age 70 ± 8 years, 62 % women), 46 (19 %) had an ABI ≤0.9 and 136 (57 %) had PP >65 mmHg, with a negative relationship between them (R = −0.386, p < 0.0001). A PP >65 mmHg was associated with an ABI ≤ 0.9 in the logistic regression model (OR 3.46, 95 % CI 1.07–11.2, p = 0.038). Continuous PP levels also correlated negatively with ABI (β −0.0014, 95 % CI −0.0024 to −0.0004, p = 0.005). The sensitivity of a PP >65 mmHg to predict a low ABI was 85 %, and the specificity was 50 %. In contrast, the sensitivity of blood pressure ≥140/90 mmHg was 27 % and the specificity was 10 %. The area under the curve for the predictive value of a PP >65 mmHg was 0.673 (95 % CI 0.609–0.736), and that of a blood pressure ≥140/90 mmHg was 0.371 (95 % CI 0.30–0.443), with a significant difference between them (p < 0.0001). Conclusions: PP calculation may be a simple tool to detect candidates for ABI testing in population-based studies.
KW - Ankle-brachial index
KW - Atahualpa Project
KW - Peripheral artery disease
KW - Population-based study
KW - Pulse pressure
UR - https://www.scopus.com/pages/publications/84941111031
U2 - 10.1007/s40292-015-0103-6
DO - 10.1007/s40292-015-0103-6
M3 - Artículo
C2 - 25986077
AN - SCOPUS:84941111031
SN - 1120-9879
VL - 22
SP - 275
EP - 280
JO - High Blood Pressure and Cardiovascular Prevention
JF - High Blood Pressure and Cardiovascular Prevention
IS - 3
ER -