Author(s): Del Brutto OH, Sedler MJ, Mera RM, Lama J, Gruen JA, et al.
Background: An abnormal ankle-brachial index has been associated with overt stroke and coronary heart disease, but little is known about its relationship with silent cerebral small vessel disease.
Aim: To assess the value of ankle-brachial index as a predictor of silent small vessel disease in an Ecuadorian geriatric population.
Methods: Stroke-free Atahualpa residents aged ≥60 years were identified during a door-to-door survey. Ankle-brachial index determinations and brain magnetic resonance imaging were performed in consented persons. Ankle-brachial index ≤0.9 and ≥1.4 were proxies of peripheral artery disease and noncompressible arteries, respectively. Using logistic regression models adjusted for age, gender, and cardiovascular health status, we evaluated the association between abnormal ankle-brachial index with silent lacunar infarcts, white matter hyperintensities, and cerebral microbleeds.
Results: Mean age of the 224 participants was 70 ± 8 years, 60% were women, and 80% had poor cardiovascular health status. Ankle-brachial index was ≤0.90 in 37 persons and ≥1.4 in 17. Magnetic resonance imaging showed lacunar infarcts in 27 cases, moderate-to-severe white matter hyperintensities in 47, and cerebral microbleeds in 26. Adjusted models showed association of lacunar infarcts with ankle-brachial index ≤ 0.90 (OR: 3.72, 95% CI: 1.35-10.27, P = 0.01) and with ankle-brachial index ≥ 1.4 (OR: 3·85, 95% CI: 1.06-14.03, P = 0.04). White matter hyperintensities were associated with ankle-brachial index ≤ 0.90 (P = 0.03) and ankle-brachial index ≥ 1.4 (P = 0.02) in univariate analyses. There was no association between ankle-brachial index groups and cerebral microbleeds.
Conclusions: In this population-based study conducted in rural Ecuador, apparently healthy individuals aged ≥60 years with ankle-brachial index values ≤0.90 and ≥1.4 are almost four times more likely to have a silent lacunar infarct. Ankle-brachial index screening might allow recognition of asymptomatic people who need further investigation and preventive therapy.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/25580986
Author(s): Criqui MH, Aboyans V
Author(s): Criqui MH, Langer RD, Fronek A, Feigelson HS, Klauber MR, et al.
Author(s): Grenon SM, Vittinghoff E, Owens CD, Conte MS, Whooley M, et al.
Author(s): McDermott MM, Liu K, Greenland P, Guralnik JM, Criqui MH, et al.
Author(s): Newman AB, Haggerty CL, Kritchevsky SB, Nevitt MC, Simonsick EM
Author(s): de Liefde II, Hoeks SE, van Gestel YR, Klein J, Bax JJ, et al.
Author(s): Feringa HH, Bax JJ, van Waning VH, Boersma E, Elhendy A, et al.
Author(s): Lee JY, Lee SW, Lee WS, Han S, Park YK, et al.
Author(s): Gronewold J, Hermann DM, Lehmann N, Kröger K, Lauterbach K, et al.
Author(s): Garg PK, Tian L, Criqui MH, Liu K, Ferrucci L, et al.
Author(s): Gardner AW, Montgomery PS, Parker DE
Author(s): Bartelink ML, Stoffers HE, Biesheuvel CJ, Hoes AW
Author(s): Fokkenrood HJ, Bendermacher BL, Lauret GJ, Willigendael EM, Prins MH, et al.
Author(s): Kruidenier LM, Nicolaï SP, Rouwet EV, Peters RJ, Prins MH, et al.
Author(s): Vemulapalli S, Dolor RJ, Hasselblad V, Schmit K, Banks A, et al.
Author(s): Kruidenier LM, Nicolaï SP, Hendriks EJ, Bollen EC, Prins MH, et al.
Author(s): Bendermacher BL, Willigendael EM, Nicolaï SP, Kruidenier LM, Welten RJ, et al.
Author(s): Mika P, Spodaryk K, Cencora A, Unnithan VB, Mika A
Author(s): Bulmer AC, Coombes JS