Price Jackie F, Stewart Marlene C W, Douglas Anne F, Murray Gordon D, Fowkes Gerald F R
Division of Community Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, Scotland.
Eur J Cardiovasc Prev Rehabil. 2008 Jun;15(3):370-5. doi: 10.1097/HJR.0b013e3282f8b36a.
An increasing interest is observed in the use of the ankle brachial index (ABI, ratio of systolic blood pressure at the ankle to that in the arm) to assess cardiovascular risk. The aim of this study was to provide information on the distribution of ABI in a large healthy population, essential for planning implementation of ABI measurement in preventive strategies in the general population.
Cross-sectional survey of the ABI was conducted in 28,980 men and women aged over 50 years, living in central Scotland and free of clinical cardiovascular disease.
The ABI was approximately normally distributed in both men (mean 1.06, SD 0.13) and women (mean 1.01, SD 0.11). A total of 10.9% of participants had an ABI<or=0.90, the most common cutpoint used to indicate increased cardiovascular risk. This percentage was higher for women (13.6%) than for men (7.3%) and rose with increasing age and with increased deprivation (6.7% in most affluent and 14.4% in most deprived participants). Similar patterns were observed for various different ABI cutpoints (<or=0.85, <or=0.95 and <or=1.0), the use of which (as expected) had a major influence on the proportion of the population categorized as 'at risk'.
Careful consideration is required of any ABI cutpoint used to discriminate between participants at 'high' and 'low' risk of cardiovascular disease, in terms of the proportion of the population who might then qualify for preventive measures. It may also be necessary to consider different cutpoints for men and women and for different age categories.
人们越来越关注使用踝臂指数（ABI，即脚踝收缩压与手臂收缩压之比）来评估心血管风险。本研究的目的是提供关于大量健康人群中ABI分布的信息，这对于在一般人群的预防策略中规划实施ABI测量至关重要。
对居住在苏格兰中部、年龄超过50岁且无临床心血管疾病的28980名男性和女性进行了ABI横断面调查。
ABI在男性（均值1.06，标准差0.13）和女性（均值1.01，标准差0.11）中近似呈正态分布。共有10.9%的参与者ABI≤0.90，这是用于指示心血管风险增加的最常用切点。该百分比女性（13.6%）高于男性（7.3%），且随年龄增长和贫困程度增加而上升（最富裕参与者中为6.7%，最贫困参与者中为14.4%）。对于不同的ABI切点（≤0.85、≤0.95和≤1.0）也观察到类似模式，使用这些切点（正如预期的那样）对被归类为“有风险”的人群比例有重大影响。
对于用于区分心血管疾病“高”风险和“低”风险参与者的任何ABI切点，需要仔细考虑符合预防措施条件的人群比例。可能还需要考虑针对男性和女性以及不同年龄组的不同切点。
