Arterial stiffness, but not endothelium-dependent vasodilation, is related to a low Ankle-Brachial index. The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS)

Background: Arterial compliance and endothelium‐dependent vasodilation are two characteristics of the vessel wall. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study we studied the relationships between arterial compliance and endothelium‐dependent vasodilation versus the Ankle‐Brachial index (ABI), a clinically used index of peripheral artery disease. Methods: In the population‐based PIVUS study (all aged 70), arterial compliance was determined by ultrasound as the distensibility of the carotid artery and the stroke volume to pulse pressure (SV/PP) ratio by echocardiography, while endothelium‐dependent vasodilation was assessed by the invasive forearm technique with acetylcholine (EDV) and brachial artery ultrasound (FMD) in 519 subjects in whom the Ankle‐Brachial index was investigated. Results: After adjustments for gender and Framingham risk score, distensibility in the carotid artery and the SV/PP ratio were significantly reduced in subjects with a reduced ABI (<0·9) in both legs (n = 15, P = 0·0006 and P = 0·0003, respectively). Endothelium‐dependent vasodilation was not significantly related to a reduced ABI. Conclusion: A reduced arterial compliance, but not endothelium‐dependent vasodilation, was related to a low ABI in both legs after adjustment for major risk factors, suggesting that atherosclerosis in the leg arteries is associated with arterial compliance also in other parts of the vasculature.