Korean J Fam Pract 2019; 9(2): 161-166  https://doi.org/10.21215/kjfp.2019.9.2.161
Association between Resting Heart Rate and Borderline Ankle-Brachial Index Among the Health Screen Examinees
Sa-Ra Kwon, Byoungjin Park*
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
Byoungjin Park, Tel: +82-31-331-8710, Fax: +82-31-331-5551, E-mail: bjpark96@yuhs.ac, ORCID: http://orcid.org/0000-0003-1733-5301
Received: July 18, 2018; Revised: August 28, 2018; Accepted: November 1, 2018; Published online: April 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The ankle-brachial index (ABI) is a simple, noninvasive clinical test that is useful in the diagnosis of peripheral artery disease (PAD). The borderline ABI value is 0.91–0.99 and has also been reported in endothelial dysfunction and preclinical PAD. We investigated the relationship between resting heart rate as a surrogate marker of autonomic balance and borderline ABI in apparently healthy individuals.
Methods: We evaluated the association between resting heart rate and borderline ABI in 618 participants (348 male and 270 female) in a health examination program. The odds ratios for borderline ABI were calculated using a multivariable logistic regression analysis after adjusting for confounding variables across heart rate quartiles (Q1≤56, Q2=57–62, Q3=63–68, and Q4≥69 beats/min).
Results: The overall prevalence of borderline ABI was 13.9%. The age- and sex-adjusted resting heart rate was significantly higher in the borderline ABI group than in the control group (66.9±0.9 vs. 63.0±0.4 beats/min, P<0.001). The odds ratios (95% confidence intervals) for the borderline ABI in each heart rate quartile were 1.00, 1.04 (0.43–2.52), 1.69 (0.73–3.93), and 3.52 (1.55–7.97) after adjusting for age, sex, smoking status, alcohol intake, regular exercise, body mass index, systolic blood pressure, fasting plasma glucose level, triglyceride level, high-density lipoprotein-cholesterol level, white blood cell count, C-reactive protein level, uric acid level, γ-glutamyltransferase level, hypertension medication, diabetes medication, and dyslipidemia medication.
Conclusion: These findings indicate that a higher resting heart rate is independently associated with borderline ABI.
Keywords: Heart Rate; Ankle-Brachial Index; Peripheral Arterial Disease
References
  1. Perret-Guillaume C, Joly L, Benetos A. Heart rate as a risk factor for cardiovascular disease. Prog Cardiovasc Dis 2009; 52: 6-10.
    Pubmed CrossRef
  2. Aune D, Sen A, ó’Hartaigh B, Janszky I, Romundstad PR, Tonstad S, et al. Resting heart rate and the risk of cardiovascular disease, total cancer, and allcause mortality - a systematic review and dose-response meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2017; 27: 504-17.
    Pubmed CrossRef
  3. Aune D, Ó Hartaigh B, Vatten LJ. Resting heart rate and the risk of type 2 diabetes: a systematic review and dose--response meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis 2015; 25: 526-34.
    Pubmed CrossRef
  4. WOCN Clinical Practice Wound Subcommittee, 2005. Ankle Brachial Index: quick reference guide for clinicians. J Wound Ostomy Continence Nurs 2012; 39(2 Suppl): S21-9.
    Pubmed CrossRef
  5. Doobay AV, Anand SS. Sensitivity and specificity of the ankle-brachial index to predict future cardiovascular outcomes: a systematic review. Arterioscler Thromb Vasc Biol 2005; 25: 1463-9.
    Pubmed CrossRef
  6. McDermott MM, Liu K, Criqui MH, Ruth K, Goff D, Saad MF, et al. Anklebrachial index and subclinical cardiac and carotid disease: the multi-ethnic study of atherosclerosis. Am J Epidemiol 2005; 162: 33-41.
    Pubmed CrossRef
  7. Kajikawa M, Maruhashi T, Iwamoto Y, Iwamoto A, Matsumoto T, Hidaka T, et al. Borderline ankle-brachial index value of 0.91-0.99 is associated with endothelial dysfunction. Circ J 2014; 78: 1740-5.
    Pubmed CrossRef
  8. Tanaka S, Kaneko H, Kano H, Matsuno S, Suzuki S, Takai H, et al. The predictive value of the borderline ankle-brachial index for long-term clinical outcomes: an observational cohort study. Atherosclerosis 2016; 250: 69-76.
    Pubmed CrossRef
  9. Natsuaki C, Inoguchi T, Maeda Y, Yamada T, Sasaki S, Sonoda N, et al. Association of borderline ankle-brachial index with mortality and the incidence of peripheral artery disease in diabetic patients. Atherosclerosis 2014; 234:360-5.
    Pubmed CrossRef
  10. Tao J, Li D, Dong Y, Wu S. [Relationship between resting heart rate and brachial-ankle pulse wave velocity in healthy Chinese population]. Chin J Cardiol 2014; 42: 686-92. Chinese.
    Pubmed
  11. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation 2012; 126:2890-909.
    Pubmed CrossRef
  12. Syvänen K, Korhonen P, Partanen A, Aarnio P. Endothelial function in a cardiovascular risk population with borderline ankle-brachial index. Vasc Health Risk Manag 2011; 7: 97-101.
    Pubmed KoreaMed CrossRef
  13. Park BJ, Lee HR, Shim JY, Lee JH, Jung DH, Lee YJ. Association between resting heart rate and arterial stiffness in Korean adults. Arch Cardiovasc Dis 2010; 103: 246-52.
    Pubmed CrossRef
  14. Lee SH, Choi SH, Kim EK, Yang JH, Song YB, Hahn JY, et al. Borderline ankle-brachial index is associated with poor short-term clinical outcome after coronary artery intervention. Atherosclerosis 2016; 249: 186-90.
    Pubmed CrossRef
  15. Jose AD, Collison D. The normal range and determinants of the intrinsic heart rate in man. Cardiovasc Res 1970; 4: 160-7.
    Pubmed CrossRef
  16. Shankar A, Klein BE, Klein R. Relationship between white blood cell count and incident hypertension. Am J Hypertens 2004; 17: 233-9.
    Pubmed CrossRef
  17. Das UN. Beneficial effect(s) of n-3 fatty acids in cardiovascular diseases: but, why and how? Prostaglandins Leukot Essent Fatty Acids 2000; 63: 351-62.
    Pubmed CrossRef
  18. Tracey KJ. The inflammatory reflex. Nature 2002; 420: 853-9.
    Pubmed CrossRef
  19. Jee SH, Park JY, Kim HS, Lee TY, Samet JM. White blood cell count and risk for all-cause, cardiovascular, and cancer mortality in a cohort of Koreans. Am J Epidemiol 2005; 162: 1062-9.
    Pubmed CrossRef
  20. Nakanishi N, Yoshida H, Matsuo Y, Suzuki K, Tatara K. White blood-cell count and the risk of impaired fasting glucose or Type II diabetes in middleaged Japanese men. Diabetologia 2002; 45: 42-8.
    Pubmed CrossRef
  21. Lee YJ, Lee JW, Kim JK, Lee JH, Kim JH, Kwon KY, et al. Elevated white blood cell count is associated with arterial stiffness. Nutr Metab Cardiovasc Dis 2009; 19: 3-7.
    Pubmed CrossRef

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