Arterial compliance across the spectrum of ankle-brachial index: The multiethnic study of atherosclerosis

Scott M. Lilly, David R. Jacobs, Richard Kronmal, David Alan Bluemke, Michael Criqui, Joao Lima, Matthew Allison, Daniel Duprez, Patrick Segers, Julio A. Chirinos

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: A low ankle-brachial index is associated with cardiovascular disease and reduced arterial compliance. A high ankle-brachial index is also associated with an increased risk of cardiovascular events. We tested the hypothesis that subjects with a high ankle-brachial index demonstrate a lower arterial compliance. In addition, we assessed whether pulse pressure amplification is increased among subjects with a high ankle-brachial index. Methods: We studied 6814 adults enrolled in the multiethnic study of atherosclerosis who were, by definition, free of clinical cardiovascular disease at baseline. Differences in total arterial compliance (ratio of stroke volume to pulse pressure), aortic and carotid distensibility (measured with magnetic resonance imaging and duplex ultrasound, respectively) were compared across ankle-brachial index subclasses (≤0.90, 0.91-1.29; ≥1.30) with analyses adjusted for cardiovascular risk factors and subclinical atherosclerosis. Results: Peripheral arterial disease was detected in 230 (3.4%) and high ABI in 648 (9.6%) of subjects. Those with high ankle-brachial index demonstrated greater aortic/radial pulse pressure amplification than those with a normal ankle-brachial index. In adjusted models aortic and carotid distensibility as well as total arterial compliance, were lowest among those with ankle-brachial index ≤0.9 (p<0.01 vs.all), but were not reduced in subjects with an ankle-brachial index ≥1.3. Conclusion: Lower aortic, carotid and total arterial compliance is not present in subjects free of overt cardiovascular disease and with a high ankle-brachial index. However, increased pulse pressure amplification contributes to a greater ankle-brachial index in the general population and may allow better characterization of individuals with this phenotype.

Original languageEnglish (US)
Pages (from-to)691-696
Number of pages6
Issue number2
StatePublished - Apr 2014


  • Atherosclerosis
  • Cardiovascular disease
  • Medial artery calcification
  • Vascular compliance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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