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International Journal of Hypertension
Volume 2012, Article ID 163807, 7 pages
Clinical Study

Risk Factors Related to Low Ankle-Brachial Index Measured by Traditional and Modified Definition in Hypertensive Elderly Patients

Department of Clinical Medicine, State University of Rio de Janeiro, Avenida 28 de Setembro 77, Sala 329, 20551-030 Rio de Janeiro, RJ, Brazil

Received 7 February 2012; Revised 4 April 2012; Accepted 13 April 2012

Academic Editor: Wille Oigman

Copyright © 2012 Raphael Monteiro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Peripheral arterial disease (PAD) increases with age and ankle-brachial index (ABI) ≤ 0.9 is a noninvasive marker of PAD. The purpose of this study was to identify risk factors related to a low ABI in the elderly using two different methods of ABI calculation (traditional and modified definition using lower instead of higher ankle pressure). A cross-sectional study was carried out with 65 hypertensive patients aged 65 years or older. PAD was present in 18% of individuals by current ABI definition and in 32% by modified method. Diabetes, cardiovascular diseases, metabolic syndrome, higher levels of systolic blood pressure and pulse pressure, elevated risk by Framingham Risk Score (FRS), and a higher number of total and antihypertensive drugs in use were associated with low ABI by both definitions. Smoking and LDL-cholesterol were associated with low ABI only by the modified definition. Low ABI by the modified definition detected 9 new cases of PAD but cardiovascular risk had not been considered high in 3 patients when calculated by FRS. In conclusion, given that a simple modification of ABI calculation would be able to identify more patients at high risk, it should be considered for cardiovascular risk prediction in all elderly hypertensive outpatients.