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 /ADVANCE/ PITTSBURGH, July 27 /PRNewswire/ -- A specific relationship between systolic blood pressure levels in the arm and ankle appears to be an important predictor of morbidity and mortality among the elderly, particularly women, according to two University of Pittsburgh studies reported in the July 28 issue of the Journal of the American Medical Association (JAMA).
 The indicator investigated in the two studies is the ankle/arm index (AAI). The AAI is the systolic blood pressure in the ankle divided by the systolic blood pressure in the arm. The systolic blood pressure is the top or peak blood pressure. When there is an obstruction of blood flow in the leg, the AAI will be less than 1.0. An AAI of less than 0.9 may indicate athero-sclerosis of the legs and is correlated with disease in other major vessels.
 "We found that a low AAI was predictive of future heart disease and stroke. People with a low AAI should be considered for aggressive therapy to modify risk factors for heart disease," said Anne Newman, M.D., M.P.H., lead author of one of the JAMA papers and co-author of the other. Newman is an assistant professor of epidemiology, Pitt Graduate School of Public Health (GSPH), and assistant professor of medicine, Medical College of Pennsylvania at Allegheny General Hospital.
 An AAI less than 0.9 was also associated with most major cardiovascular disease risk factors, such as smoking and high cholesterol.
 "In patients with an AAI lower than 0.7, we found the prognosis of death from cardiovascular disease to be worse than the prognosis associated with some types of cancers," said Lewis Kuller, M.D., Dr.P.H., professor and chairman, Pitt GSPH department of epidemiology and an author of both papers.
 The study involved 1,537 participants in the Systolic Hypertension in the Elderly Program or SHEP, involving 11 centers around the United States, including Pitt, and 1,492 participants in the Study of Osteoporotic Fractures (SOF) at Pitt. All participants were more than 60 years.?
 "The ankle/arm index offers physicians an inexpensive, noninvasive test that can be used in the physician's office or screening center to identify high-risk older adults who are good candidates for aggressive treatment," said Newman.
 Aggressive treatment could include the use of lipid-lowering drugs, smoking cessation and other ways to lower blood pressure levels.
 Co-authors of the SHEP paper were Kim Sutton-Tyrrell, Dr.P.H., and Molly Vogt, Ph.D., both of the Pitt GSPH. Co-authors of the SOF paper were Vogt and Jane Cauley, Dr.P.H., of Pitt's GSPH, and Stephen Hulley, M.D., of the University of California, San Francisco.
 -0- 7/27/93/1600
 /CONTACT: Suzie Hunt or Lauren Ward, 412-624-2607, or fax, 412-624-3184, both of Health Sciences News Bureau/

CO: University of Pittsburgh ST: Pennsylvania IN: HEA SU:

CD -- PG015 -- 6189 07/27/93 11:34 EDT
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Date:Jul 27, 1993

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