title: Low frequency of a decreased ankle brachial index and associated conditions in the practice of internal medicine in a Turkish population sample.
abstract: OBJECTIVE
  Peripheral arterial disease (PAD) is a less known condition in the practice of internal medicine, mostly due to lack of specific symptoms and low rates of physician awareness. However, cardiovascular disease (CVD) incidence is not significantly different among patients with symptomatic or asymptomatic disease. Ankle brachial index (ABI) measurement is an easy and cost-effective tool for the diagnosis of PAD. In the present study, frequency of low ABI and associated factors were investigated in the setting of internal medicine practice.
  
  
  METHODS
  Patients over 70 years of age and patients between 50 and 69 years with CVD or at least one atherothrombosis risk factor were included in the study. ABI was determined with handheld Doppler. Measurements were determined for both lower extremities. Lower of the right or left ABIs was taken as the final value. Low ABI was defined as ≤0.9.
  
  
  RESULTS
  A total of 303 subjects between 50 and 83 years of age were enrolled (female/male: 186/117). Mean ABI was 1.14±0.15. A low ABI was detected in 15 cases (4.95%). Prevalence was 7% in females and 1.7% in males (P=0.039). Low ABI value was not associated with any of the demographic parameters, presence of major risk factors or basic laboratory values. A high ABI was found by 5.6%.
  
  
  CONCLUSIONS
  In the present study, frequency of PAD as determined by ABI was found lower than those reported previously in most European countries. Nonetheless, our results showed that PAD affects at least 1 in 20 outpatients in the practice of internal medicine.
authors.affiliation: Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Gezer
authors.forename: I
authors.initials: I
authors.lastname: Tasci
authors.forename: O
authors.initials: O
authors.lastname: Demir
authors.forename: C
authors.initials: C
authors.lastname: Acikel
authors.forename: M
authors.initials: M
authors.lastname: Cakar
authors.forename: K
authors.initials: K
authors.lastname: Saglam
authors.forename: H
authors.initials: H
authors.lastname: Kutsi Kabul
authors.forename: M
authors.initials: M
authors.lastname: Fatih Bulucu
authors.forename: R
authors.initials: R
authors.lastname: Acar
authors.forename: K
authors.initials: K
authors.lastname: Ozturk
authors.forename: M
authors.initials: M
authors.lastname: Inanc Dogan
authors.forename: B
authors.initials: B
authors.lastname: Koc
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D018608:Ultrasonography, Doppler