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

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Author(s)

    • Kojima Iwao
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Research and Development Department, Omron Healthcare, Co., Ltd.
    • Ninomiya Toshiharu
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Hata Jun
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Fukuhara Masayo
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Hirakawa Yoichiro
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Mukai Naoko
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Yoshida Daigo
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
    • Kitazono Takanari
    • Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
    • Kiyohara Yutaka
    • Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University

Abstract

<b><i>Aim</i></b>: 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.<br><b><i>Methods</i></b>: 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.<br><b><i>Results</i></b>: During the follow-up period, 134subjects experienced cardiovascular events. The incidence of cardiovascular disease across the ABI values was significantly different (<i>p</i><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.<br><b><i>Conclusions</i></b>: 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.

Journal

  • Journal of Atherosclerosis and Thrombosis

    Journal of Atherosclerosis and Thrombosis 21(9), 966-973, 2014

    Japan Atherosclerosis Society

Codes

  • NII Article ID (NAID)
    130004690937
  • Text Lang
    ENG
  • ISSN
    1340-3478
  • Data Source
    J-STAGE 
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