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Associations between physical activity and ankle-brachial index : the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Memarian, Ensieh LU ; Hamrefors, Viktor LU orcid ; Kharraziha, Isabella LU orcid ; Bergström, Göran ; Blomberg, Anders ; Malinovschi, Andrei ; Östgren, Carl Johan ; Ekblom, Örjan ; Engström, Gunnar LU and Gottsäter, Anders LU (2024) In BMC Cardiovascular Disorders 24(1).
Abstract

Background: The ankle–brachial index (ABI) is the ratio of the ankle and brachial systolic blood pressures. In the clinical setting, low ABI (< 0.9) is an indicator of peripheral atherosclerosis, while high ABI (> 1.4) is a sign of arterial stiffness and calcification. The purpose of the current study was to investigate the association between ABI and physical activity levels, measured by accelerometer. Methods: The Swedish CArdioPulmonary bioImage Study (SCAPIS) is a Swedish nationwide population-based cross-sectional cohort for the study of cardiovascular and pulmonary diseases, in which individuals aged 50–64 years were randomly invited from the general population. The study population with data on ABI, physical activity, and... (More)

Background: The ankle–brachial index (ABI) is the ratio of the ankle and brachial systolic blood pressures. In the clinical setting, low ABI (< 0.9) is an indicator of peripheral atherosclerosis, while high ABI (> 1.4) is a sign of arterial stiffness and calcification. The purpose of the current study was to investigate the association between ABI and physical activity levels, measured by accelerometer. Methods: The Swedish CArdioPulmonary bioImage Study (SCAPIS) is a Swedish nationwide population-based cross-sectional cohort for the study of cardiovascular and pulmonary diseases, in which individuals aged 50–64 years were randomly invited from the general population. The study population with data on ABI, physical activity, and sedentary time based on accelerometry was 27,737. Differences between ABI categories and associations to sedentary behavior, moderate to vigorous physical activity (MVPA), and other metabolic characteristics were compared. ABI was categorized as low, ABI ≤ 0.9, borderline, ABI 0.91–0.99, normal, ABI 1.0-1.39, and high, ABI ≥ 1.4. Results: Prevalence of low ABI was higher in the most sedentary quartiles compared to the least sedentary (0.6% vs. 0.1%, p < 0.001). The most sedentary individuals also exhibited higher BMI, higher prevalence of diabetes and hypertension. The proportion of wake time spent in MVPA was lowest in those with low ABI (0.033 ± 0.004; p < 0.001) and highest in those with ABI > 1.4 (0.069 ± 0.001; p < 0.001) compared to those with normal ABI. Compared to normal ABI, the proportion of sedentary time was highest in those with low ABI (0.597 ± 0.012; p < 0.001) and lowest in those with ABI > 1.4 (0.534 ± 0.002; p = 0.004). Conclusion: This population-based study shows that middle-aged individuals with ABI > 1.4 have the highest level of physical activity, while individuals with a lower ABI, especially those with ABI < 0.9, are less active and spend more time sedentary. Future studies are needed to understand the relationships between ABI, physical activity, and the risk of peripheral arterial and cardiovascular disease in the general population.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ABI, Accelerometer, CVD, Physical activity, Sedentary time
in
BMC Cardiovascular Disorders
volume
24
issue
1
article number
459
publisher
BioMed Central (BMC)
external identifiers
  • pmid:39198765
  • scopus:85202190715
ISSN
1471-2261
DOI
10.1186/s12872-024-04137-x
language
English
LU publication?
yes
id
cffc7b58-79f9-4cba-b9b0-ff7ebac647a5
date added to LUP
2024-10-28 15:17:10
date last changed
2025-07-22 14:16:44
@article{cffc7b58-79f9-4cba-b9b0-ff7ebac647a5,
  abstract     = {{<p>Background: The ankle–brachial index (ABI) is the ratio of the ankle and brachial systolic blood pressures. In the clinical setting, low ABI (&lt; 0.9) is an indicator of peripheral atherosclerosis, while high ABI (&gt; 1.4) is a sign of arterial stiffness and calcification. The purpose of the current study was to investigate the association between ABI and physical activity levels, measured by accelerometer. Methods: The Swedish CArdioPulmonary bioImage Study (SCAPIS) is a Swedish nationwide population-based cross-sectional cohort for the study of cardiovascular and pulmonary diseases, in which individuals aged 50–64 years were randomly invited from the general population. The study population with data on ABI, physical activity, and sedentary time based on accelerometry was 27,737. Differences between ABI categories and associations to sedentary behavior, moderate to vigorous physical activity (MVPA), and other metabolic characteristics were compared. ABI was categorized as low, ABI ≤ 0.9, borderline, ABI 0.91–0.99, normal, ABI 1.0-1.39, and high, ABI ≥ 1.4. Results: Prevalence of low ABI was higher in the most sedentary quartiles compared to the least sedentary (0.6% vs. 0.1%, p &lt; 0.001). The most sedentary individuals also exhibited higher BMI, higher prevalence of diabetes and hypertension. The proportion of wake time spent in MVPA was lowest in those with low ABI (0.033 ± 0.004; p &lt; 0.001) and highest in those with ABI &gt; 1.4 (0.069 ± 0.001; p &lt; 0.001) compared to those with normal ABI. Compared to normal ABI, the proportion of sedentary time was highest in those with low ABI (0.597 ± 0.012; p &lt; 0.001) and lowest in those with ABI &gt; 1.4 (0.534 ± 0.002; p = 0.004). Conclusion: This population-based study shows that middle-aged individuals with ABI &gt; 1.4 have the highest level of physical activity, while individuals with a lower ABI, especially those with ABI &lt; 0.9, are less active and spend more time sedentary. Future studies are needed to understand the relationships between ABI, physical activity, and the risk of peripheral arterial and cardiovascular disease in the general population.</p>}},
  author       = {{Memarian, Ensieh and Hamrefors, Viktor and Kharraziha, Isabella and Bergström, Göran and Blomberg, Anders and Malinovschi, Andrei and Östgren, Carl Johan and Ekblom, Örjan and Engström, Gunnar and Gottsäter, Anders}},
  issn         = {{1471-2261}},
  keywords     = {{ABI; Accelerometer; CVD; Physical activity; Sedentary time}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cardiovascular Disorders}},
  title        = {{Associations between physical activity and ankle-brachial index : the Swedish CArdioPulmonary bioImage Study (SCAPIS)}},
  url          = {{http://dx.doi.org/10.1186/s12872-024-04137-x}},
  doi          = {{10.1186/s12872-024-04137-x}},
  volume       = {{24}},
  year         = {{2024}},
}