title: [Value of the ankle-brachial index in cardiovascular risk stratification of patients without known atherotrombotic disease. MERITO study].
abstract: OBJECTIVE
  Peripheral arterial disease detected by measurement of ankle-brachial index enables the identification of asymptomatic patients with target organ damage. We have investigated the prevalence of peripheral arterial disease (ankle-brachial index < 0.9), and its potential clinical-therapeutic impact, in patients without known atherotrombotic disease from internal medicine practices.
  
  
  METHODS
  It was a multicenter, cross-sectional, observational study. Outpatients aged 50 through 80 years, with either diabetes or a SCORE risk estimation of at least 3%, were enrolled.
  
  
  RESULTS
  A total of 1,519 subjects (58% men) were evaluated, 917 with diabetes (61%). The mean age (standard deviation) was 66.2 (8.3) years. The prevalence of an ankle-brachial index < 0.9 was 26.19%. In multiple logistic regressions the risk factors associated to an ankle-brachial index < 0.9 were age, sedentary lifestyle, smoking, macroalbuminuria, and heart rate. There was a significant relationship between the ankle-brachial index and the SCORE risk estimation. With respect to the therapeutic aims of the patients with an ankle-brachial index < 0.9, only 21% were taking antiplatelet drugs, 26% showed low density lipoproteins-cholesterol values < 100 mg/dl (53% < 130 mg/dl), and 16% displayed recommended blood pressure levels.
  
  
  CONCLUSIONS
  Measurement of ankle-brachial is useful to reclassify as high risk a significant proportion of patients without known previous atherotrombotic disease. The ankle-brachial index should be incorporated into routine cardiovascular evaluation, particularly in subjects with diabetes or a score risk assessment > or = 3%.
authors.affiliation: Unidad de Insuficiencia Cardíaca y Riesgo Vascular del Anciano, Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España. luis.manzano@uah.es
authors.forename: Luis
authors.initials: L
authors.lastname: Manzano
authors.forename: José María
authors.initials: JM
authors.lastname: Mostaza
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez
authors.forename: Marc
authors.initials: M
authors.lastname: Cairols
authors.forename: Rubén
authors.initials: R
authors.lastname: Redondo
authors.forename: Pedro
authors.initials: P
authors.lastname: Valdivielso
authors.forename: Rafael
authors.initials: R
authors.lastname: Monte
authors.forename: Julio César
authors.initials: JC
authors.lastname: Blázquez
authors.forename: Eva María
authors.initials: EM
authors.lastname: Ferreira
authors.forename: Isabel
authors.initials: I
authors.lastname: Trouillhet
authors.forename: Jesús J
authors.initials: JJ
authors.lastname: González-Igual
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sánchez-Zamorano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications; D000842:Ankle; D002318:Cardiovascular Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires