title: [Usefulness of the ankle-arm index for detection of peripheral arterial disease in a working population of Junta de Andalucía at Málaga].
abstract: OBJECTIVE
  Detection of asymptomatic peripheral arterial disease increases the risk of vascular morbibity and mortality. We aimed to estimate the prevalence of clinical and subclinical peripheral arterial disease using the ankle-arm index (AAI) as diagnostic tool in a working population.
  
  
  METHODS
  We included 450 workers, older than 50 years old, attending voluntary regular health check-up at Centro de Prevención de Riesgos Laborales de la Junta de Andalucía in Málaga (Spain). We recorded clinical and anthopometrical data. Blood samples were taken after an overnight fast. Vascular risk was calculated using Framinghan and SCORE scales. Every participant was asked for symptoms of intermittent claudicatio and AAI was measured. AAI was considered normal within 0.9-1.3 values.
  
  
  RESULTS
  Most of our workers were at low- or moderate vascular risk. Only 48 (10.6%) of individuals had an abnormal AAI: 9 (2%) showed an AAI<0.9 and 39 (8.6%) showed an AAI>1.3. An AAI<0.9 was found in 19% of those with a SCORE risk > or = 5%, and in 11% of those having a Framinghan risk > or = 20%. Intermittent claudication was present in 4 out of 9 (44%) of those having an AAI<0.9 and in 7 out of 402 (1.7%) with a normal AAI.
  
  
  CONCLUSIONS
  Systematic screening of peripheral arterial disease using the AAI is not recommended in active working population over 50 years-old of age. Thus, AAI measurement is indicated only for those individuals suffering from intermitent claudicatio and those who are at moderate- or high vascular risk.
authors.affiliation: Centro de Prevención de Riesgos Laborales, Consejería de Empleo, Junta de Andalucía, Málaga, España.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Alonso
authors.forename: Pedro
authors.initials: P
authors.lastname: Valdivielso
authors.forename: María
authors.initials: M
authors.lastname: Josefa Zamudio
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Sánchez Chaparro
authors.forename: Francisca
authors.initials: F
authors.lastname: Pérez
authors.forename: Heliodoro
authors.initials: H
authors.lastname: Ramos
authors.forename: Pedro
authors.initials: P
authors.lastname: González Santos
mesh_terms: D055109:Ankle Brachial Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain