Association of ankle brachial pressure index with heart rate variability in a rural screening clinic

Peripheral vascular disease (PVD) can be associated with atherosclerosis and/ or peripheral neuropathy, which can be characterized by impairment of sensory, motor or autonomic nervous system. A noninvasive test to detect PVD is the ankle brachial pressure index (ABPI). Autonomic nervous system function can be determined by assessing heart rate variability from an ECG recording. No clear association between PVD and cardiac autonomic dysfunction has been demonstrated to date.Over 800 records of individuals attending a diabetes complications screening clinic were analyzed. ABPI was determined from the ankle and brachial blood pressure recordings. Ten minutes 3 lead ECGs were also recorded as well as age, gender and blood pressure. HRV was determined using linear and nonlinear measures. A Decision Guidance Management System (DGMS) was applied to identifY novel associations between HRV and ABPI The number of participants in the low tertile range HRV, increased significantly as ABPI increased from 1.0 to >1.2 (p=235). This is the first time a consistent association between ABPI and HRV in asymptomatic individuals has been shown suggesting that HRV can be used as a surrogate marker for identification of PVD and indicates a pathophysiological relationship between PVD and autonomic nervous system dysfunction.