ORIGINAL ARTICLES   

Panminerva Medica 2003 June;45(2):145-50

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Is ankle/arm pressure predictive for cardiovascular mortality in older patients living in nursing homes?

Zanocchi M., Ponzetto M., Scarafiotti C., Maero B., Giona E., Francisetti F., Nicola E., Corsinovi L., Amati D., Fabris F.

Geriatric Section, Department of Medical and Surgical Disciplines, University of Turin, Turin, Italy

Aim. To iden­ti­fy wheth­er Ankle/Arm Index (AAI) is a pre­dic­tive fac­tor for car­di­o­vas­cu­lar mor­tal­ity in insti­tu­tion­al­ised eld­er­ly.
Methods. Design: lon­gi­tu­di­nal descrip­tive ­study. Setting: 2 ­large nurs­ing ­homes in Turin, Italy. Subjects: 418 depen­dent eld­er­ly (83 ­males, 335 ­females, ­mean age 83.7±8.5 y, ­range 55-102) liv­ing in the nurs­ing ­homes. Measurements: the prev­a­lence of periph­er­al arte­ri­al dis­ease (PAD) was eval­u­at­ed ­using a Doppler Ultrasound meas­ure­ment of AAI (Ankle/Arm ­blood pres­sure Index). Death caus­es accord­ing to ICD-9-CM ­were ascer­tained on ­patient’s clin­i­cal ­records.
Results. Diagnosis of PAD was ­made in 122 sub­jects (29.2%) ­with AAI <0.90. After a 3 year fol­low-up 203 ­patients (48.6%) ­died. The pres­ence of PAD was not relat­ed to ­total mor­tal­ity or to mor­tal­ity for ischem­ic ­heart dis­ease (IHD), cereb­ro­vas­cu­lar dis­ease or oth­er caus­es. IHD mor­tal­ity was sig­nif­i­cant­ly and inde­pen­dent­ly relat­ed to low hae­mog­lo­bin val­ues, pre­vi­ous cereb­ro­vas­cu­lar dis­ease, poly­phar­ma­cy and ­poor mobil­ity con­di­tions.
Conclusion. The prev­a­lence of PAD is ­high in nurs­ing ­home res­i­dents. AAI is not pre­dic­tive for IHD mor­tal­ity in ­this pop­u­la­tion. In ­very ­frail eld­er­ly tra­di­tion­al ­risk fac­tors and PAD are ­less impor­tant pre­dic­tors of ­death com­pared to ­poor func­tion­al stat­us, nutri­tion­al fac­tors and pre­vi­ous car­di­o­vas­cu­lar dis­ease.