Sažetak | Objectives: The objectives of this thesis are to investigate the patterns of ankle-brachial
pressure index (ABPI) in the population of two Adriatic islands and the city of Split, and to
determine the relationship between ABPI and key cardiovascular risk factors including blood
pressure, serum lipids, and sedentary lifestyle.
Methods: This thesis uses data from the 10,001 Dalmatians project and in total included
data from 2,921 subjects. Of these, 991 subjects originated from the island of Vis, 918 from the
island of Korčula and 1,012 from the city of Split.
Results: The vast majority of patients presented with a good ABPI, close to 1.0. There
were 235 (4.8%) subjects with values of 0.8 or lesser, compared to 35 (0.7%) with an ABPI
above 1.2. A low ABPI, below 0.8, was more prevalent among men (121; 10.7% vs 114; 6.4%
in women; P<0.001), while a higher ABPI, above 1.2, was more prevalent in the elderly
(63.2±10.9 for higher ABPI vs 53.7±14.7 for normal ABPI; P<0.001). The systolic blood
pressure for the Vis group was 137.8±23.8 mmHg, for the Korčula group was 139.5±21.7
mmHg, and for the Split group was 130.2±19.4 mmHg. The diastolic blood pressure for the Vis
group was 80.6±11.2 mmHg, for the Korčula group was 81.8±9.9 mmHg, and for the Split
group was 76.8±10.3 mmHg. The correlation between ABPI and serum lipids was not
significant (serum cholesterol: r=-0.05, P=0.464; serum triglycerides: r=0.02, P=0.751; HDL:
r=-0.04, P=0.677; LDL: r=-0.05, P=0.391). The ABPI demonstrated a significant correlation
with physical activity (r=0.08, P<0.001).
Conclusion: A low ABPI, below 0.8, was more prevalent among men, on the other hand,
a higher ABPI, above 1.2, was more prevalent in the elderly. Blood pressures measured in the
six designated ABPI locations indicated significant differences among the three sub-samples,
with some exceptions in pair-wise comparisons between Vis and Korčula. The correlation
between ABPI and serum lipids was not significant. The ABPI correlated significantly with
physical activity. Since further crucial data is missing, we cannot draw conclusions about the
connection between ABPI as a predictor of cardiovascular risk. Additional studies are needed
to explore the use of ABPI as a tool in cardiovascular risk assessment. |
Sažetak (hrvatski) | Ciljevi: Ciljevi ovog diplomskog rada su istražiti obrasce gležanj-brahijalnog indeksa tlaka
(ABPI) u populaciji dva jadranska otoka i grada Splita, te utvrditi odnos između ABPI i ključnih
čimbenika kardiovaskularnog rizika uključujući krvni tlak, serumske lipide i sjedilački način
života.
Metode: Ovaj rad koristi podatke iz projekta 10.001 Dalmatinac i ukupno uključuje
podatke od 2.921 ispitanika. Od toga je 991 subjekt podrijetlom s otoka Visa, 918 s otoka
Korčule i 1012 s područja grada Splita.
Rezultati: velika većina pacijenata imala je dobar ABPI, blizu 1,0. Bilo je 235 (4,8%)
ispitanika s vrijednostima 0,8 ili manjim, u usporedbi s 35 (0,7%) s ABPI iznad 1,2. Nizak
ABPI, ispod 0,8, bio je zastupljeniji među muškarcima (121; 10,7% naspram 114; 6,4% kod
žena; P<0,001), dok je viši ABPI, iznad 1,2, bio zastupljeniji u starijih osoba (63,2±10,9 za viši
ABPI naspram 53,7±14,7 za normalan ABPI; P<0,001). Sistolički krvni tlak za višku skupinu
bio je 137,8±23,8 mmHg, za korčulansku 139,5±21,7 mmHg, a za splitsku 130,2±19,4 mmHg.
Dijastolički krvni tlak za višku skupinu bio je 80,6±11,2 mmHg, za korčulansku 81,8±9,9
mmHg, a za splitsku 76,8±10,3 mmHg. Korelacija između ABPI i serumskih lipida nije bila
značajna (serumski kolesterol: r=-0,05, P=0,464; serumski trigliceridi: r=0,02, P=0,751; HDL:
r=-0,04, P=0,677; LDL: r=-0,05, P=0,391). ABPI je pokazao značajnu korelaciju s tjelesnom
aktivnošću (r=0,08, P<0,001).
Zaključak: Nizak ABPI, ispod 0,8, bio je zastupljeniji kod muškaraca, s druge strane,
viši ABPI, iznad 1,2, bio je zastupljeniji kod starijih osoba. Krvni tlakovi izmjereni na šest
označenih ABPI lokacija ukazali su na značajne razlike između tri poduzorka, uz neke iznimke
u usporedbama parova između Visa i Korčule. Korelacija između ABPI i lipida u serumu nije
bila značajna. ABPI je značajno korelirao s tjelesnom aktivnošću. Budući da nedostaju daljnji
ključni podaci, ne možemo donositi zaključke o povezanosti između ABPI kao prediktora
kardiovaskularnog rizika. Potrebne su dodatne studije kako bi se istražila upotreba ABPI kao
alata u procjeni kardiovaskularnog rizika. |