Ankle Brachial Pressure Index: identifying cardiovascular risk and improving diagnostic accuracy

Bhasin, Nikhil; Scott, Daniel

doi:10.1177/014107680710000103

Cited by 19 publications

(9 citation statements)

References 13 publications

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“…The predictive value of ABPI in cardiovascular morbidity and mortality is similar to that of traditional Framingham risk factors 49. McKenna and colleagues50 evaluated a low ABPI as an independent risk factor for mortality.…”

Section: Association Between the Abpi Ratio And Cardiovascular Morbidmentioning

confidence: 90%

Ankle Brachial Pressure Index (ABPI): An update for practitioners

Al-Qaisi

Nott²,

King³

et al. 2009

VHRM

183

124

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Peripheral vascular disease affects some 12%–14% of the general population, and the majority of people with the disease are asymptomatic. The Ankle Brachial Pressure Index (ABPI) test is widely used by a diverse range of practitioners (in the community and hospital setting) in order to screen asymptomatic patients, diagnose patients with clinical symptoms, and to monitor patients who have had radiological or surgical intervention. This paper explains the theoretical basis of the ABPI test, as well as the relevance of the common modifications of the test. It explores the background to the quoted normal ranges for the ABPI test. It reviews the large body of literature that has developed on the association between ABPI and cardiovascular risk, as well as ABPI as a predictor for cardiovascular morbidity and mortality, highlighting the evidence that can inform practice. The review looks critically at the limitations of the ABPI test, providing practitioners with an evidence-based update on the importance and challenges of standardizing ABPI methodology. This paper highlights the influence of the key technical aspects of the ABPI test that all practitioners need to consider in order to be able to make more reliable and informed management decisions based on ABPI findings.

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Section: Association Between the Abpi Ratio And Cardiovascular Morbidmentioning

confidence: 90%

Ankle Brachial Pressure Index (ABPI): An update for practitioners

Al-Qaisi

Nott²,

King³

et al. 2009

VHRM

183

124

View full text Add to dashboard Cite

show abstract

“…The ankle-brachial pressure index (ABPI), defined as the systolic blood pressure obtained at the ankle divided by the systolic blood pressure obtained at the brachial artery while the patient is lying down, is a universally accepted measurement that can accurately identify PAD. 15 It is a simple, quick, non-invasive tool whose measurement requires a hand-held 5–10 MHz Doppler probe and a blood pressure cuff. 16 ABPI is 95% sensitive and 100% specific in detecting patients with PAD and healthy subjects, respectively, when compared to angiography.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of ankle brachial pressure index: A systematic review and meta-analysis

et al. 2016

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Purpose To synthesize and quantify the excess risk of morbidity and mortality in individuals with low ankle-brachial pressure index. Methods Electronic databases were searched to identify studies investigating morbidity and mortality outcomes in individuals undergoing ankle-brachial pressure index measurement. Meta-analysis of the outcomes was performed using fixed- or random-effects models. Uncertainties related to varying follow-up periods among the studies were resolved by meta-analysis of time-to-event outcomes. Results Forty-three observational cohort studies, enrolling 94,254 participants, were selected. A low ankle-brachial pressure index (<0.9) was associated with a significant risk of all-cause mortality (risk ratio: 2.52, 95% CI 2.26-2.82, P < 0.00001); cardiovascular mortality (risk ratio: 2.94, 95% CI 2.72-3.18, P < 0.00001); cerebrovascular event (risk ratio: 2.17, 95% CI 1.90-2.47, P < 0.00001); myocardial infarction (risk ratio: 2.28, 95% CI 2.07-2.51, P < 0.00001); fatal myocardial infarction (risk ratio: 2.81, 95% CI 2.33-3.40, P < 0.00001); fatal stroke (risk ratio: 2.28, 95% CI 1.80-2.89, P < 0.00001); and the composite of myocardial infarction, stroke, and death (risk ratio: 2.29, 95% CI 1.87-2.81, P < 0.00001). Similar findings resulted from analyses of individuals with asymptomatic PAD, individuals with cardiovascular or cerebrovascular co-morbidity, and patients with diabetes. Conclusions A low ankle-brachial pressure index is associated with an increased risk of subsequent cardiovascular and cerebrovascular morbidity and mortality. Randomised controlled trials are required to investigate the effectiveness of screening for PAD in asymptomatic and undiagnosed individuals and to evaluate benefits of early treatment of screen-detected PAD.

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“…Participants enrolled in the control groups will also need to demonstrate an absence of symptoms of intermittent claudication [ 17 ] and an ABPI of >0.8 bilaterally. Any participants who demonstrate ABPIs of >1.3 will also be referred to the vascular specialist for review of inclusion [ 18 ]. Participants will not be excluded on grounds of a history of peripheral vascular reconstruction provided they demonstrate adequate peripheral circulation at the time of screening as based on the criteria listed above.…”

Section: Methodsmentioning

confidence: 99%

“…We utilised the combination of ABPI and claudication symptom questionnaire to identify peripheral artery disease as previously reported [ 17 ]. This combination is thought to provide a better means of detecting peripheral artery disease, especially since falsely elevated ABPI values are common in patients with diabetes mellitus [ 18 , 41 ].…”

Section: Methodsmentioning

confidence: 99%

Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol

et al. 2015

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BackgroundFoot ulceration is the main precursor to lower limb amputation in patients with type 2 diabetes worldwide. Biomechanical factors have been implicated in the development of foot ulceration; however the association of these factors to ulcer healing remains less clear. It may be hypothesised that abnormalities in temporal spatial parameters (stride to stride measurements), kinematics (joint movements), kinetics (forces on the lower limb) and plantar pressures (pressure placed on the foot during walking) contribute to foot ulcer healing. The primary aim of this study is to establish the biomechanical characteristics (temporal spatial parameters, kinematics, kinetics and plantar pressures) of patients with plantar neuropathic foot ulcers compared to controls without a history of foot ulcers. The secondary aim is to assess the same biomechanical characteristics in patients with foot ulcers and controls over-time to assess whether these characteristics remain the same or change throughout ulcer healing.Methods/DesignThe design is a case–control study nested in a six-month longitudinal study. Cases will be participants with active plantar neuropathic foot ulcers (DFU group). Controls will consist of patients with type 2 diabetes (DMC group) and healthy participants (HC group) with no history of foot ulceration. Standardised gait and plantar pressure protocols will be used to collect biomechanical data at baseline, three and six months. Descriptive variables and primary and secondary outcome variables will be compared between the three groups at baseline and follow-up.DiscussionIt is anticipated that the findings from this longitudinal study will provide important information regarding the biomechanical characteristic of type 2 diabetes patients with neuropathic foot ulcers. We hypothesise that people with foot ulcers will demonstrate a significantly compromised gait pattern (reduced temporal spatial parameters, kinematics and kinetics) at base line and then throughout the follow-up period compared to controls. The study may provide evidence for the design of gait-retraining, neuro-muscular conditioning and other approaches to off-load the limbs of those with foot ulcers in order to reduce the mechanical loading on the foot during gait and promote ulcer healing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-015-0057-7) contains supplementary material, which is available to authorized users.

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Ankle Brachial Pressure Index: identifying cardiovascular risk and improving diagnostic accuracy

Cited by 19 publications

References 13 publications

Ankle Brachial Pressure Index (ABPI): An update for practitioners

Ankle Brachial Pressure Index (ABPI): An update for practitioners

Prognostic significance of ankle brachial pressure index: A systematic review and meta-analysis

Lower limb biomechanical characteristics of patients with neuropathic diabetic foot ulcers: the diabetes foot ulcer study protocol

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