A low or high ankle brachial index increased the risk for all-cause mortality in Native Americans.

M e t h o d s Design: Cohort study with a mean follow-up of 8.3 years. Setting: Native American communities in the United States. Participants: 4393 Native Americans 45 to 74 years of age (mean age 56 y, 59% men) who were followed for all-cause and CVD mortality. Risk factors: Baseline ABI categorized as low (ABI < 0.9), normal (ABI ≥ 0.9 and ≤ 1.4), or high (ABI > 1.4). Potential confounders included age, sex, diabetes, lipid levels, hypertension, renal function, fibrinogen levels, and smoking history. Associations between categories of ABI and all-cause mortality (with adjustment for confounding) were assessed using Cox regression models. Outcomes: All-cause and CVD mortality.