Prevalence of symptomatic and asymptomatic peripheral arterial disease and the value of the ankle-brachial index to stratify cardiovascular risk.
OBJECTIVE
To determine the prevalence of ankle-brachial index (ABI)<0.9 and symptomatic peripheral arterial disease (PAD), association with cardiovascular risk factors (CVRF), and impact of adding ABI measurement to coronary heart disease (CHD) risk screening.


METHODS
Population-based cross-sectional survey of 6262 participants aged 35-79 in Girona, Spain.


METHODS
Standardized measurements (CVRF, ABI, 10-year CHD risk) and history of intermittent claudication (IC), CHD, and stroke were recorded. ABI<0.9 was considered equivalent to moderate-to-high CHD risk (> or =10%).


RESULTS
ABI<0.9 prevalence was 4.5%. Only 0.62% presented low ABI and IC. Age, current smoker, cardiovascular disease, and uncontrolled hypertension independently associated with ABI<0.9 in both sexes; IC was also associated in men and diabetes in women. Among participants 35-74 free of cardiovascular disease, 6.1% showed moderate-to-high 10-year CHD risk; adding ABI measurement yielded 8.7%. Conversely, the risk function identified 16.8% of these participants as having 10-year CHD risk>10%. In participants 75-79 free of cardiovascular disease, the prevalence of ABI<0.9 (i.e., CHD risk> or =10%) was 11.9%.


CONCLUSIONS
ABI<0.9 is relatively frequent in those 35-79, particularly over 74. However, IC and CHD risk> or =10% indicators are often missing. Adding ABI measurement to CHD-risk screening better identifies moderate-to-high cardiovascular risk patients.
Ramos
R
R
Research on Inflammatory and Cardiovascular Disorders Program (RICAD), Unitat de Lípids i Epidemiologia Cardiovascular (ULEC), Cardiovascular, Epidemiology and Genetics Research Group (EGEC), Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain. rramos.girona.ics@gencat.cat
Quesada
M
M
Solanas
P
P
Subirana
I
I
Sala
J
J
Vila
J
J
Masiá
R
R
Cerezo
C
C
Elosua
R
R
Grau
M
M
Cordón
F
F
Juvinyà
D
D
Fitó
M
M
Isabel Covas
M
M
Clarà
A
A
Angel Muñoz
M
M
Marrugat
J
J
D000328:Adult; D000368:Aged; D000842:Ankle / Q000098:blood supply*; D001794:Blood Pressure; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors