title: [The relevance of the ankle-arm index to the reclassification of cardiovascular risk in asymptomatic hypertensive middle-aged males].
abstract: OBJECTIVE
  The ankle-brachial index allows for the detection of subclinical cardiovascular disease and risk, by diagnosing peripheral arterial disease and arterial calcification. Asymptomatic hypertensive men, between 45-55 years and with the suspicion of low risk, could be an important population group to benefit from this technique. The aim of the study was to compare the frequency of abnormal ankle-brachial index (subclinical peripheral arterial disease and arterial calcification) between asymptomatic hypertensive and non-hypertensive men, of the same age and suspicion of low risk.
  
  
  METHODS
  Two hundred and forty-four asymptomatic men (122 hypertensive and 122 non-hypertensive), between 45 and 55 years and an REGICOR index<10, were voluntarily recruited using consecutive sampling. Complete anamnesis, physical examination, laboratory tests and ankle-brachial index determination were carried out on all patients.
  
  
  RESULTS
  We detected abnormal ankle-brachial index values in 9.8% (12 cases) of the hypertensive subjects and in 1.6% (2 cases) of non-hypertensive subjects (P=.006). In the multivariate analysis, hypertension was significantly associated with an abnormal ankle-brachial index (P<.026) (odds ratio [OR] 5.9, 95% confidence interval [95% CI] 1.2-28.3), smoking (P=.018) (OR 2.7; 95% CI 1.2-6.2) and abdominal obesity (P=.005) (OR 2.8; 95% CI 1.3-5.9).
  
  
  CONCLUSIONS
  The population group analyzed in this study might be considered as an overriding segment for detecting subclinical cardiovascular disease and risk with the ankle-brachial index. Further studies are needed to establish the prevalence of abnormal ankle-brachial index in this population in order to assess its efficiency.
authors.affiliation: Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Salud Adrià, Institut Català de la Salut, Barcelona, España. Electronic address: voliveras.bcn.ics@gencat.cat.
authors.forename: Víctor
authors.initials: V
authors.lastname: Oliveras
authors.affiliation: Servicio de Epidemiología Clínica, Consorci Sanitari Integral, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Martín-Baranera
authors.affiliation: Unitat de Risc Vascular, Clínica Sagrada Familia, Barcelona, España.
authors.forename: Maya
authors.initials: M
authors.lastname: Gracia
authors.affiliation: Unitat de Suport a la Recerca Barcelona Ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, España.
authors.forename: José Luís
authors.initials: JL
authors.lastname: Del Val
authors.affiliation: Centro de Salud Verdaguer, Institut Català de la Salut, Sant Joan Despí, Barcelona, España.
authors.forename: Miquel
authors.initials: M
authors.lastname: Plans
authors.affiliation: Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Institut d'Investigació Biomèdica Sant Pau (IIRB), Barcelona, España.
authors.forename: Núria
authors.initials: N
authors.lastname: Pujol-Moix
mesh_terms: D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D016022:Case-Control Studies; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D061205:Vascular Calcification / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology
keywords: Ankle-brachial index; Asymptomatic patients; Cardiovascular risk; Hipertensión arterial; Hypertension; Middle-aged men; Pacientes asintomáticos; Riesgo cardiovascular; Varones de mediana edad; Índice tobillo-brazo