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Stroke Research and Treatment
Volume 2010, Article ID 729391, 6 pages
Research Article

Ankle Blood Pressure and Pulse Pressure as Predictors of Cerebrovascular Morbidity and Mortality in a Prospective Follow-Up Study

1Department of Clinical Physiology, Helsinki Deaconess Institute, Alppikatu 2, 00530 Helsinki, Finland
2National Institute for Health and Welfare (THL), Helsinki, Finland

Received 23 August 2010; Revised 24 November 2010; Accepted 23 December 2010

Academic Editor: Bruce Ovbiagele

Copyright © 2010 Heikki J. Hietanen 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.


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 < . 0 0 0 1 ) 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.