title: Pulse pressure and subclinical peripheral artery disease.
abstract: Ankle-brachial index (ABI) measurement offers an easily available method to diagnose peripheral artery disease (PAD) and systemic atherosclerosis in early stage and thus to identify high-risk individuals for preventive interventions. The objective of this study was to assess the most practical criteria for the measurement of ABI in subjects with high cardiovascular risk. We examined 972 asymptomatic, middle-aged high-risk subjects without manifested cardiovascular disease or previously diagnosed diabetes. The prevalence of PAD (defined as ABI0.90) and borderline PAD (0.91-1.00) were 5% (95% confidence interval (CI) 4-7%) (49/972) and 20% (95% CI 18-23%) (192/972), respectively. In multivariate analysis, female gender (odds ratio (OR) 0.71 (95% CI 0.53-0.97)), current smoking (OR 2.14 (95% CI 1.47-3.11)) and pulse pressure (OR 1.03 for each increase of 1 mm Hg (95% CI 1.01-1.04)) were associated with low ABI. Measuring ABI in subjects who smoke or have pulse pressure >65 mm Hg seems to be worthwhile.
authors.affiliation: 1] Satakunta Hospital District, Pori, Finland [2] Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland [3] Department of Internal Medicine, Central Satakunta Health Federation of Municipalities, Harjavalta, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Korhonen
authors.affiliation: 1] Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland [2] Department of General Practice, University of Helsinki, Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.affiliation: Department of Surgery, Satakunta Hospital District, Pori, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Aarnio
mesh_terms: D000367:Age Factors; D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects