A low ankle brachial index is associated with an increased risk of cardiovascular disease: The hisayama study

Iwao Kojima, Toshiharu Ninomiya, Jun Hata, Masayo Fukuhara, Yoichiro Hirakawa, Naoko Mukai, Daigo Yoshida, Takanari Kitazono, Yutaka Kiyohara

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Results: During the follow-up period, 134 subjects experienced cardiovascular events. The incidence of cardiovascular disease across the ABI values was significantly different (p<0.001). After adjusting for confounding factors, namely age, sex, systolic blood pressure, use of anti-hypertensive drugs, diabetes, total cholesterol, high-density lipoprotein cholesterol, obesity, smoking, alcohol intake and regular exercise, individuals with a low ABI were at 2.40-fold (95% confidence interval [CI] 1.14-5.06) greater risk of cardiovascular disease and 4.13-fold (95% CI 1.62-10.55) greater risk of coronary heart disease.

Conclusions: Our findings suggest that individuals with an ABI of ≤ 0.90 have an increased risk of cardiovascular events, independent from traditional risk factors, in the general Japanese population.

Aim: Peripheral artery disease (PAD), defined as a decreased ankle brachial index (ABI), is a risk factor for cardiovascular disease; however, few studies have assessed the relationship between a low ABI and cardiovascular risks in Asian populations. We herein examined the relationship between the ABI and the development of cardiovascular disease in a Japanese community.

Methods: A total of 2,954 community-dwelling Japanese individuals without prior cardiovascular disease ≥ 40 years of age were followed up for an average of 7.1 years. The subjects’ ABIs were categorized into the three groups: low (≤ 0.90), borderline (0.91-0.99) and normal (1.00-1.40). We estimated the relationship between the ABI and cardiovascular risk using a Cox proportional hazards model.

Original languageEnglish
Pages (from-to)966-973
Number of pages8
JournalJournal of atherosclerosis and thrombosis
Issue number9
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Biochemistry, medical


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