To study the association between the ankle-brachial pressure index (ABPI), premature death and the need for surgical treatment for lower limb ischaemia.
Population based cohort study.
Three hundred and fifty-three men and women, 50-89 years old, underwent a leg pain questionnaire and measurement of ABPI and was then followed for 10 years.
All cause mortality, vascular procedures and major amputations.
A low ABPI was independently associated with premature all cause mortality in the multiple regression analysis, carrying a relative risk of 3.4 (95% confidence interval 2.0-5.9) and 2.1 (1.3-3.3) for ABPIs or=1.0. Individuals with an ABPI in the interval 0.81-0.99 suffered only a slight, not statistically significant risk increase compared to normals. A low ABPI at baseline implied a continuous constant increased risk of death throughout the study period. The same risk was observed among elderly (70-89, median 77 years), and in the middle aged (50-69, median 63 years) individuals. The vast majority of those subjected to vascular intervention or major amputation during follow-up had an ABPI