Finger Systolic Blood Pressure Index (FBPI) measurement: a useful tool for the evaluation of arterial disease in patients with systemic sclerosis

2020 ◽  
Author(s):  
Sophie Blaise ◽  
Carine Boulon ◽  
Marion Mangin ◽  
Patricia Senet ◽  
Isabelle Lazareth ◽  
...  
2020 ◽  
Vol 131 ◽  
pp. 104029
Author(s):  
Sophie Blaise ◽  
Joël Constans ◽  
Laure Pellegrini ◽  
Patricia Senet ◽  
Isabelle Lazareth ◽  
...  

Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 560-570 ◽  
Author(s):  
Benjamin Thurston ◽  
Joseph Dawson

Objectives Ankle brachial pressure index (ABPI) is an invaluable tool for assessing the severity of peripheral arterial disease. In addition, it can be used as an independent marker of cardiovascular risk, with a predictive ability similar to the Framingham criteria. Identification of an abnormal ABPI should therefore trigger aggressive cardiac risk factor modulation for a patient. Unfortunately, the significance of abnormal ABPIs is poorly understood within the general medical community. This is compounded by the influence of various comorbidities on accurate measurement of ABPI, potentially leading to a wide variability in readings that need to be considered before interpretation in these patient populations. We aim to address these issues by revealing several common misunderstandings and pitfalls in ABPI measurement, describing accurate methodology, and highlighting patient cohorts in whom additional or alternative approaches may be required. Methods We present a narrative review of the role of ABPI in both the community and hospital setting. We have performed a literature review, exploring the validity and reproducibility of methodology for obtaining ABPI, alongside the utility of ABPI in different clinical scenarios. Results The measurement of ABPI is often performed incorrectly. Common pitfalls include inadequate patient preparation, failure to obtain the blood pressure from the correct lower limb artery in patients with tibial disease, failure to account for differences in brachial blood pressure between the arms, inappropriately chosen equipment and patient factors such as highly calcified arteries. Standardisation of methodology greatly improves reliability of the test. Exercise ABPI can identify significant peripheral arterial disease in patients with normal resting ABPI. In addition to its role in peripheral arterial disease, ABPI measurement has a role in assessing venous ulcers, entrapment syndromes and injured extremities; conversely, it has a more limited utility in the diabetic population. Conclusions A thorough understanding of the correct technique and associated limitations of ABPI measurement is essential in accurately generating and interpreting the data it provides. With this knowledge, the ABPI is an invaluable tool to help manage patients with peripheral arterial disease. Perhaps more importantly, ABPI can be used to identify and risk stratify patients with asymptomatic peripheral arterial disease, itself a major indicator of significant underlying cardiovascular disease. With the emergence of best medical therapy, targeted pharmacotherapy and lifestyle changes can reduce the risk of major cardiovascular events in high-risk patients by approximately 30%, particularly in diabetic patients. Therefore, the utility of ABPI transgresses vascular surgery, with an essential role in general practice and public health.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Tiffany M Powell ◽  
Robert J Glynn ◽  
Mark A Creager ◽  
Paul M Ridker ◽  
Aruna D Pradhan

Background : Prospective data pertaining to risk factors for peripheral arterial disease (PAD) in women are sparse. Few studies have evaluated blood pressure, including uncontrolled hypertension, and PAD onset in women. Methods and Results : We examined the relationship between blood pressure and development of confirmed symptomatic PAD (n=116 events) in a prospective cohort study of 39,261 female health professionals aged ≤ 45 years without diagnosed vascular disease at baseline. Median follow-up was 11.4 years. Women were first grouped according to baseline presence of uncontrolled hypertension, defined as reported systolic blood pressure (SBP)≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and pharmacologic treatment status. SBP and DBP were then modeled as continuous and categorical exposures irrespective of treatment status. Pulse pressure (PP) and mean arterial pressure (MAP) were also assessed. Age-adjusted and multivariable-adjusted risk estimates were derived from Cox proportional hazards models. Women with treated but uncontrolled hypertension had the highest risk of symptomatic PAD (0.67 events per 1000 person-years). Adjusted hazard ratios (HRs) compared to women without hypertension were 1.1 (95% CI, 0.5–2.3) for women who were treated and controlled, 1.7 (95% CI, 1.0 –3.0) for women untreated and uncontrolled, and 2.3 (95% CI, 1.4 – 4.0) for women treated and uncontrolled (p-trend<0.001). When hypertension was examined using continuous and categorical measures, there was a 33% increase in risk per 10 mmHg of SBP (95% CI, 18 to 47%) and a positive gradient in multivariable-adjusted risk according to SBP category (<120, 120 –139, 140 –159, and ≤ 160 mmHg); HRs were 1.0, 1.6, 2.8, and 4.3 (p-trend<0.001), respectively. We also considered DBP, PP, and MAP. While individually predictive, none was a stronger predictor than SBP with none adding predictive ability beyond SBP. Conclusions : Uncontrolled hypertension is associated with incident symptomatic PAD in women. Among blood pressure variables assessed, SBP is the best single predictor. These data support a strong prognostic role for systolic blood pressure in the development of peripheral atherosclerosis in women.


1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 406-408 ◽  
Author(s):  
Alan T. Webb ◽  
Edwina A. Brown

The prevalence of coronary, cerebral, and peripheral arterial disease was assessed using a standard cardiovascular questionnaire in a cohort of 70 patients on continuous ambulatory peritoneal dialysis (CAPD). Symptomatic vascular disease was found in 47% of patients, 72% of whom were smokers and 30% diabetic. In 39% of these patients vascular disease was evident prior to the commencement of peritoneal dialysis. A case control study matching for age and sex revealed patients with vascular disease to have higher median systolic blood pressure (162 mmHg vs 150 mmHg, p=0.026), cholesterol (6.60 mmol/L vs 6.00 mmol/L, p=0.014), and LDL cholesterol (4.80 mmol/L vs 3.80 mmol/L, p=0.009). Vascular disease is common in patients on peritoneal dialysis, a considerable proportion of whom have the disease prior to the commencement of dialysis. Elevated systolic blood pressure and hypercholesterolemia, but not smoking, are most closely associated with vascular disease in these patients.


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