Association of Interankle Systolic Blood Pressure Difference with Peripheral Vascular Disease and Left Ventricular Mass Index

Background: An interankle systolic blood pressure (SBP) difference has been associated with overall and cardiovascular mortality. We investigated whether an association existed between this difference and ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and echocardiographic parameters.

Methods: A total of 1,059 patients referred for echocardiographic examination were included in the study. The 4 limb blood pressures were measured simultaneously using an ABI-form device.

Results: We performed multivariate forward analysis to determine the factors associated with an interankle SBP difference ≥ 15mm Hg. An ABI < 0.9 (P < 0.001), high baPWV (P < 0.001), and increased left ventricular mass index (LVMI; P = 0.004) were associated with an interankle SBP difference ≥ 15mm Hg. Also, the addition of an interankle SBP difference ≥ 15mm Hg to a model of clinical features could significantly improve the value in predicting ABI < 0.9 (P < 0.001) and increased LVMI (P = 0.036).

Conclusions: Our study demonstrated that ABI < 0.9, high baPWV, and increased LVMI were independently associated with an interankle SBP difference ≥ 15mm Hg. Also, an interankle SBP difference ≥ 15mm Hg could offer an extra benefit in identifying patients with ABI < 0.9 and increased LVMI beyond conventional clinical features. Hence, calculation of interankle SBP difference may provide additional information for identifying patients with peripheral vascular disease and increased LVMI.