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Background: We investigate whether peripheral arterial disease (PAD) detected by ankle brachial index (ABI)

Ankle brachial index (ABI) has increasingly been used in general practice to identify patients with low ABI at high cardiovascular risk. However there is no consensus on the clinical significance of high ABI. The aim of our study was to compare large artery stiffness as a marker of cardiovascular risk in patients with low (1.4). Methods: 911 patients from the Czech post-MONICA study (a randomly selected 1% representative population sample, mean age 54±13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device. Results: Of 911 patients, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in patients with low and high ABI compared with normal ABI group (11.1±2.8, 8.3±2.3, p

Objective: To investigate predictors of increase in aortic pulse wave velocity (aPWV) in elderly subjects free from overt cardiovascular disease. Design and Method: The present study included 90 lecture attendees (“university of 3rd age”) who were examined at baseline and after a median follow-up of 9.5 years, including the aPWV measurement using Sphygmocor. At baseline, they were aged 66.9±5.1 years, 80.0% were women, 37.8% of subjects had arterial hypertension, 5.6% diabetes mellitus, and 82.2% hyperlipidemia. We used multiple linear regression analyses to assess predictors of change in aPWV. As independent covariates we considered: sex, age, body mass index, mean arterial pressure (MAP), heart rate, fasting glucose, total cholesterol, smoking, alcohol intake and observer. Results: The aPWV increased from 9.4 to 10.3m/s; P=0.022. While accounting for covariates, aPWV increased significantly with three factors: a 1–standard deviation change in heart rate (8.5bpm), in MAP (12.4mm Hg) and in fasting glucose (0.93mmol/l) were associated with increased aPWV amounting to 0.76m/s (95% CI: 0.23 to 1.30; P=0.0061), 0.71m/s (95% CI: 0.20 to 1.23; P=0.0079) and 0.57m/s (95% CI: 0.08 to 1.07; P=0.024), respectively. Conclusions: In elderly subjects without manifest cardiovascular disease, mechanical load, as demonstrated by the positive association with heart rate and MAP, plays a major role in the aortic stiffening. Among metabolic factors, glucose concentration but not lipid parameters is associated with increase in aortic stiffness, possible via glycation of connective tissue within arterial wall.