Background: The ankle blood pressure is commonly used as a ratio to the brachial blood pressure, called ankle-brachial index (ABI). Very few studies have considered the independent value of the ankle blood pressure without indexing it to the brachial blood pressure. We examined the value of ankle blood pressure, together with the exercise blood pressure, as a predictor of cardiovascular (CVD) and total mortality.

Elevated ankle blood pressure (ABP) may be one of the earliest signs of subclinical atherosclerosis. However, its behavior in different degrees of atherosclerotic vascular damage has not been well characterized. We examined the association of ABP and brachial exercise blood pressure with the incidence of future coronary events. A cohort of 3808 consecutive ambulatory persons (mean age 50 years, 34% women), referred to a symptom-limited exercise test and free of cardiovascular events at baseline, was prospectively followed up for 15 years. Altogether, 383 (80 fatal and 303 non-fatal) incident coronary events occurred. Cox proportional hazards models, adjusting for several conventional risk factors, were used to analyse the independent association of ABP with the risk of an incident coronary heart disease (CHD) event. Persons with normal ankle, brachial resting and brachial exercise blood pressures were taken as the reference group. Other groups were formed on the basis of ankle and exercise blood pressures and compared with the reference group. Even in persons among whom the elevated ABP was the only abnormal finding, the multivariate adjusted hazard ratio (HR) of a future CHD event was significantly elevated (HR ¼ 1.60, 95% confidence interval 1.20-2.14, Po0.0001). In general, the HRs were higher for fatal events than for non-fatal events. The measurement of ABP could be an inexpensive and non-invasive tool to detect elevated risk of a CHD event.

Background and Objective. We examined the association of elevated ankle blood pressure (ABP), together with exercise blood pressure, with incident cerebrovascular (CV) morbidity and mortality in a prospective follow-up study of 3,808 patients. The results were compared with pulse pressure, another indicator of arterial stiffness. Methods. Patients with normal ankle and exercise brachial blood pressures were taken as the reference group. Pulse pressure was considered as quartiles with the lowest quartile as the reference category. Results. A total of 170 subjects had a CV event during the follow-up. Multivariate adjusted hazard ratio of a CV event was 2.24 (95% CI 1.43–3.52, P < .0001) in patients with abnormal ABP. The pulse pressure was significant only in the model adjusted for age and sex. Conclusion. The risk of a future CV event was elevated already in those patients among whom elevated ABP was the only abnormal finding. As a risk marker, ABP is superior to the pulse pressure.

Growth hormone markedly improved adult height in subjects with PWS when compared to historical data. The cumulative dose of growth hormone correlated with reduction in body fat; nevertheless, patients remained severely obese.

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