Association between ankle-brachial blood pressure index with all-cause and cardiovascular mortality in adults without arterial stiffness

• Published in: BMC geriatrics Vol. 23; no. 1; pp. 1 - 635
• Main Authors: Meng, Zhe, Jiang, Yaohui, Xu, Chang, Zheng, Huifen, Li, Haiyu
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 09.10.2023; BioMed Central; BMC
• Subjects: Adults; All-cause mortality; Analysis; Ankle; Ankle-brachial blood pressure index; Arterial calcification; Arteries; Blood pressure; Body mass index; Calcification; Cardio-cerebrovascular mortality; Cardiovascular diseases; Care and treatment; Diabetes; Diagnosis; Disease; Ethnicity; Gender; Geriatrics; Health aspects; Heart rate; Hypertension; Measurement; Mortality; Nonlinear systems; Nutrition; Nutritional status; Older people; Peripheral arterial disease; Population; Questionnaires; Regression analysis; Risk factors; Stenosis; Surveys; Veins & arteries; China
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-023-04332-z

Abstract Purpose To explore the relationship between ankle-brachial blood pressure index (ABPI) and all-cause or cardiovascular mortality in adults without arterial stiffness. Methods A total of 6784 participants without arterial stiffness were enrolled from National Health and Nutrition Examination Survey 1999–2004. The hazard ratio (HR) and 95% confidence interval (CI) of ABPI associating with the risk of all-cause and cardiovascular mortality was calculated by Cox proportional regression models adjusted for demographic and traditional risk factors. Dose-response relationship was explored with restricted cubic spines. Results After an average follow-up of 12.1 years, 1844 all-cause deaths and 299 cardiovascular deaths occurred. Compared with the lowest ABPI quartile, the second quartile was associated with the lowest risk of all-cause mortality (HR 0.89, 95%CI 0.79–0.98; p = 0.036) and cardiovascular mortality (HR 0.75, 95%CI 0.56–0.98; p = 0.048). Besides, dose-response analysis revealed that ABPI was nonlinearly correlated to all-cause mortality (p for nonlinearity < 0.001) and linearly correlated to cardiovascular mortality (p for nonlinearity = 0.459). Conclusions The relationship between ABPI and all-cause and cardiovascular mortality followed a L-shape curve. A lower ABPI was independently associated with an increased risk of all-cause and cardiovascular mortality in adults without arterial stiffness.