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Relationship of ankle–brachial index with all-cause mortality and cardiovascular mortality after a 3-year follow-up: the China ankle–brachial index cohort study

Journal of Human Hypertension volume 24, pages 111–116 (2010)Cite this article

Abstract

This study aimed to investigate the relationship of ankle–brachial index (ABI) with all-cause mortality and cardiovascular (CV) mortality in Chinese inpatients after 3 years of follow-up. All the participants were inpatients at high risk of atherosclerosis and enrolled from July to November 2004. A total of 3210 patients were followed up until an end point was reached or until February 2008. The mean follow-up time was 37.65±1.54 months. Patients with ABI ⩽0.4 were significantly older than other ABI categories (P<0.001) at baseline. The all-cause and CV disease (CVD) mortality were highest (37.7 and 27.5%, respectively) after a 3-year follow-up in patients with ABI ⩽0.4. There was a significant increasing tendency in mortality with decreasing ABI levels (P<0.001). The Kaplan–Meier curves of survival showed a decreasing survival rate with the ABI decreasing, not only for all-cause mortality but also for CVD mortality (P<0.001). Adjusted for other risk factors, patients with ABI ⩽0.4 were 3.105 times (95% CI 1.936–4.979) as likely to die as those with ABI in the range of 1.00–1.4; patients with ABI ⩽0.4 were about five times (95% CI 2.740–8.388) as likely to die of CVD as those with ABI in the range of 1.00–1.4. Even patients with ABI in the range of 0.41–0.90 were more than 1.5 times as likely to die (relative risk=1.534, 95% CI 1.199–1.962), or die of CVD (relative risk=2.031, 95% CI 1.479–2.789) as those with ABI in the range of 1.00–1.4. Low ABI is related to a higher all-cause and CV mortality compared with normal ABI. ABI as a marker of atherosclerosis should be routinely evaluated to assess the risk of CV mortality in Chinese patients.

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Acknowledgements

The study was sponsored by the Shanghai Educational Development Foundation.

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Author notes

  1. X Li and Y Luo: These authors contributed equally to this paper and they are the first co-authors.

Authors and Affiliations

  1. Tongji University School of Medicine, Shanghai, China

    X Li, J Li & D Hu

  2. Shanghai Tenth People's Hospital Affiliated with Tongji University, Shanghai, China

    X Li & Y Xu

  3. Shanghai Institute of Health Sciences, Nanhui, Shanghai, China,

    Y Luo

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  1. X Li
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  2. Y Luo
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  4. J Li
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Correspondence to J Li or D Hu.

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Li, X., Luo, Y., Xu, Y. et al. Relationship of ankle–brachial index with all-cause mortality and cardiovascular mortality after a 3-year follow-up: the China ankle–brachial index cohort study. J Hum Hypertens 24, 111–116 (2010). https://doi.org/10.1038/jhh.2009.49

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