G C Leng, F G R Fowkes, A J Lee, J Dunbar, E Housley, C V Ruckley et al
Leng G C, Fowkes F G R, Lee A J, Dunbar J, Housley E, Ruckley C V et al.
Use of ankle brachial pressure index to predict cardiovascular events and death: a cohort study
BMJ 1996; 313 :1440
doi:10.1136/bmj.313.7070.1440
Method of measuring ABPI
After reading this article I have a number of queries :
Baseline investigations - the description of the measurements used to
calculate the ABPI seems to be imcomplete. From this article there appears
to have been only one brachial measurement taken, and a single measurement
taken in each ankle.
Numerous authors state that to get an accurate and valid measurement
both brachial pressures should be taken, as well as both posterior tibial
and dorsalis pedis in both feet. The measurement is calculated using the
highest brachial reading overall for both left and right ankle, and the
highest of the two readings for each foot is selected for that leg, i.e.
if the left brachial systolic = 127 whilst the right = 131, then the value
of 131 is used for both calculations. If the left ankle readings are 145
and 152 then the calculation for the left ABPI = 152 / 131, etc.
Is there any reason that this method was not used in this research ?
The second query relates to the length of time resting before
measurement began. Again there is much debate as to the optimum time of
rest required before a valid measurement can be achieved. Some authors
state up to 30 minutes. How was the 10 minute figure accepted ?
Whilst I agree with the findings of this paper I think that perhaps
the method of measuring ABPI was not completely accurate, and this might
not give a true reflection of the actual levels of CV disease, and hence
alter prediction indicators.
Competing interests: No competing interests