scholarly journals The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Bolaji O. Oyelade ◽  
Akintayo D. OlaOlorun ◽  
Louis O. Odeigah ◽  
Isaac O. Amole ◽  
Olufemi S. Adediran
Keyword(s):  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Objective Assessment ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Cross Sectional ◽  
Index Measurement ◽  
Clinical Methods ◽  
History Of ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD.Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI) was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease.Results: The overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05), sex (p < 0.05), and marital status (p < 0.05). The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses.Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.

scholarly journals Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan

2016 ◽  
Vol 4 ◽  
pp. 205031211665908 ◽  
Author(s):  
Jane EA Lewis ◽  
Paul Williams ◽  
Jane H Davies
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Disease Diagnosis ◽  
Waveform Analysis ◽  
Duplex Scan ◽  
Cross Sectional ◽  
Pulse Volume ◽  
Index Measurement ◽  
Peripheral Arterial

Objectives: This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan. Methods: Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index <0.9; pulse volume waveform was graded as 2, 3 or 4; or if haemodynamically significant stenosis >50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard. Results: Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%. Conclusion: Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals.

scholarly journals Prevalence of Peripheral Arterial Disease and Associated Vascular Risk Factors in 65-Years-Old People of Northern Barcelona

2021 ◽  
Vol 10 (19) ◽  
pp. 4467
Author(s):  
Gabriela Gonçalves-Martins ◽  
Daniel Gil-Sala ◽  
Cristina Tello-Díaz ◽  
Xavier Tenezaca-Sari ◽  
Carlos Marrero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Strong Association ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Cross Sectional ◽  
Screening Programs ◽  
History Of ◽  
Peripheral Arterial ◽  
Male Subjects

Objective: To determine the prevalence and risk factors associated with peripheral arterial disease (PAD) in Northern Barcelona at 65 years of age. Methods: A single-center, cross-sectional study, including males and females 65 years of age, health care cardholders of Barcelona Nord. PAD was defined as an ankle–brachial index (ABI) < 0.9. Attending subjects were evaluated for a history of common cardiovascular risk factors. A REGICOR score was obtained, as well as a physical examination and anthropometric measurements. Results: From November 2017 to December 2018, 1174 subjects were included: 479 (40.8%) female and 695 (59.2%) male. Overall prevalence of PAD was 6.2% (95% CI: 4.8–7.6%), being 7.9% (95% CI: 5.9–9.9%) in males and 3.8% (95% CI: 2.1–5.5%) in females. An independent strong association was seen in male smokers and diabetes, with ORs pf 7.2 (95% CI: 2.8–18.6) and 1.8 (95% CI: 1.0–3.3), respectively, and in female smokers and hypertension, with ORs of 5.2 (95% CI: 1.6–17.3) and 3.3 (95% CI: 1.2–9.0). Male subjects presented with higher REGICOR scores (p < 0.001). Conclusion: Higher-risk groups are seen in male subjects with a history of smoking and diabetes and female smokers and arterial hypertension, becoming important subgroups for our primary healthcare centers and should be considered for ABI screening programs.

The arteriomobil project for peripheral arterial disease

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 345-352 ◽  
Author(s):  
Pfeiffer ◽  
Bock ◽  
Hohenberger ◽  
Kröger
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Computer Assisted ◽  
German Population ◽  
Co Morbidity ◽  
History Of ◽  
And Gender ◽  
Peripheral Arterial ◽  
Self Help Groups

Background: Peripheral Arterial Disease in Germany is underestimated with regard to incidence and the consequences. In 1997 the Federal Association of the Peripheral Arterial Disease Self Help Groups started the Arteriomobil Project to increase the awareness for venous and arterial diseases in the general population. We report peripheral arterial disease (PAD) prevalence rates and discuss the unique concept of this project. Patients and methods: The Arteriomobil is a mobile home modified to a simple investigation room with an examination couch, a Doppler equipment and a computer for data acquisition. From April 1997 to April 2007, a total of 14.785 volunteers aged 18 to 102 years (mean age ± SD: 64 ± 11 years, 63% females) were investigated. Patients were recruited as a result of their active visit to the Arteriomobil and their active participation in the investigation. In all participants the medical history was documented according to a standardized computer-assisted interview and a standardized Ankle Brachial Index (ABI) determined. Results: PAD prevalence in females (ABI < 0.9) increased from 2% in the 5th decade of life to 33% in 10th decade and in males from 4.8% to 41% accordingly. Age- and gender-adjusted odds ratios for PAD were highest in smoker: Odds ratio 2.85 (95% Confidence interval 2.5–3.2) and Diabetes mellitus 1.91 (95%CI 1.7–2.2). Hypertension and hypercholesterolemia had a lower impact. Family history of known PAD, CHD or CVD had no impact. Although 49.5% of all participants complained of "leg disorders during exercise" intermittent claudication turned out to be the most discriminating symptom for PAD 5.87 (95%IC 5.18–6.66). Previous myocardial infarction (MI) was the most frequently reported vascular co-morbidity in those with PAD (OR 2.23, 95%IC 1.9–2.7) followed by stroke (2.12, 1.7–2.7), angina pectoris (1.50, 1.3–1.8) and paresis (2.01, 1.6–2.6). The incidence of anti-platelet treatment was significantly higher in participants with coronary heart disease than in those with PAD or cerebrovascular disease. Conclusions: The Arteriomobil Project is the largest database regarding the prevalence of PAD in the German population. and the data underlines the high prevalence of PAD in Germany.

Claudication as an ‘Orphan Disease’: Rationale and Goals of Drug Therapy for Peripheral Arterial Disease

1996 ◽  
Vol 1 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Alan T Hirsch
Keyword(s):  
Peripheral Arterial Disease ◽  
Disease Progression ◽  
Critical Role ◽  
Ankle Brachial Index ◽  
Arterial Occlusion ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Current Data ◽  
History Of ◽  
Peripheral Arterial

Patients with peripheral arterial disease are often perceived to suffer from a disorder whose pathogenesis and symptoms are not amenable to drug therapies. This clinical misperception remains prevalent despite an abundance of data suggesting that diverse pharmacotherapies may modulate the natural history of this disease. Patients with chronic limb arterial occlusive disease suffer from a disease that is characterized by: (1) a prolonged asymptomatic state that can be identified by simple physical examination and confirmed by measurement of the ankle brachial index; (2) a multi-year period of symptomatic claudication; and (3) a variable rate of progression to critical limb ischemia or acute arterial occlusion. This stage-dependent disease progression is mediated via the dynamic, but as yet incompletely understood, interaction of factors that elicit endothelial dysfunction, atherogenesis, and thrombosis. Current data suggest that each of these contributory disease processes can be modulated by extant pharmacotherapies. Additionally, many novel pharmacotherapeutic agents that are currently under investigation may further improve the ability of clinicians to modulate these fundamental biologic processes. Pharmacologic therapies should be targeted to decrease the rate of limb arterial disease progression, to improve limiting symptoms, and to prolong life. Symptoms of claudication can be objectively assessed via both exercise testing and disease-specific questionnaires. The presence of lower extremity atherosclerotic disease is predictive of the presence of coronary heart disease and a foreshortened five-year survival. Current data suggest that clinical investigations should be able to effectively stratify this relative risk via use of both clinical variables (e.g., age, diabetes mellitus, tobacco use, etc.) or by measurement of the ankle brachial index (ABI). The role of the physician is to decrease suffering and to prolong life. Judicious administration of medical therapies can play a critical role in helping the vascular practitioner accomplish these goals.

scholarly journals A study to assess frequency of peripheral arterial disease in patients presenting with acute coronary syndrome

2017 ◽  
Vol 4 (5) ◽  
pp. 1276
Author(s):  
Somnath Mukherjee ◽  
Prashant Kumar ◽  
D. P. Sinha
Keyword(s):  
Acute Coronary Syndrome ◽  
Peripheral Arterial Disease ◽  
Past History ◽  
Systolic Dysfunction ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Observation Study ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Peripheral Arterial

Background: To determine the frequency of peripheral arterial disease (PAD) in patients presenting with acute coronary syndrome (ACS) and association of PAD with different risk factors of coronary artery disease (CAD) and to look for in hospital outcome of ACS patients with or without PAD.Methods: This cross-sectional observation study was undertaken in the department of cardiology, IPGME&R Hospital, Kolkata from June 2015 to August 2016 to recruit 199 consecutive patients admitted with ACS and were evaluated with detailed clinical history, physical examination, ABI (Ankle Brachial Index) measurement, echocardiography and appropriate blood investigations.Results: Among 199 total ACS patients, STEMI was the predominant mode of presentation (71.86%) and majorities were male. PAD was seen in 26 patients and mean age was 56.68±8.84 years. Factors independently related with PAD in acute coronary syndromes are hypertension (OR- 1.49; 95% CI: 0.615-3.232), diabetes (OR- 2.55;95% CI : 0.9762-6.6665), smoking (OR-2.55; 95% CI: 1.055-6.19), past history of CVA (OR-11.15;95% CI: 1.77-70.32), LV systolic dysfunction (OR-1.388; 95% CI:0.607-3.1742). 2 and 13 patients died within 7 days of admission among 26 ACS-PAD group (7.69%) and 173 ACS-non-PAD group (7.5%) respectively and most of them had STEMI.Conclusions: Significant numbers of ACS patients are having PAD and older age, male sex, diabetes, hypertension, smoking and LV systolic dysfunction were found to be independent predictors for PAD in ACS patients. Early in hospital mortality was seem to be dependent on clinical presentation, not on presence or absence of PAD.

Short stature in men is associated with subclinical peripheral arterial disease

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 486-490
Author(s):  
Arto Heikkilä ◽  
Maarit Venermo ◽  
Hannu Kautiainen ◽  
Pertti Aarnio ◽  
Päivi Korhonen
Keyword(s):  
Cardiovascular Risk ◽  
Peripheral Arterial Disease ◽  
Short Stature ◽  
Smoking Status ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Inverse Association ◽  
Cross Sectional ◽  
Peripheral Arterial ◽  
The Relationship

Abstract. Background: Peripheral arterial disease (PAD) affects approximately 202 million individuals around the world and is associated with a high risk of myocardial infarction, stroke and death. Although there is a clear inverse association between adult height and the risk of cardiovascular disease, little is known about the relationship between height and PAD. The aim of our study was to assess the relationship between subclinical PAD and height. Patients and methods: In a cross-sectional cardiovascular risk factor study in southwestern Finland, ankle brachial index (ABI) and other risk factors were measured from a total of 972 cardiovascular risk subjects derived from the general population. None of them had previously diagnosed diabetes, cardiovascular or renal disease or intermittent claudication. Subjects with an ABI ≤ 0.90 were categorized as having subclinical PAD. Results: The average age of the study subjects was 58.1 ± 6.7 years for men and 58.8 ± 6.9 years for women. The prevalence of subclinical PAD was 5 % (95 % CI 3 % − 7 %) (23/455) among men and 5 % (95 % CI 3 %−7 %) (26/517) among women. The mean ABI among men and women was 1.09 ± 0.12 and 1.08 ± 0.12, respectively. In men, there was an inverse association between height and the prevalence of subclinical PAD (p < 0.001) along with a positive association between height and ABI values (p < 0.001). In a multivariate model, height, age and current smoking status remained independent factors that were associated with subclinical PAD in men, whereas in women, only pulse pressure was associated with subclinical PAD. Conclusions: Short stature in men is associated with subclinical PAD and lower ABI values.

scholarly journals Primary care screening for peripheral arterial disease: a cross-sectional observational study

2017 ◽  
Vol 67 (655) ◽  
pp. e103-e110 ◽  
Author(s):  
Jane H Davies ◽  
Jonathan Richards ◽  
Kevin Conway ◽  
Joyce E Kenkre ◽  
Jane EA Lewis ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Peripheral Arterial Disease ◽  
Public Awareness ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Smoking History ◽  
Cross Sectional ◽  
Number Needed To Screen ◽  
Peripheral Arterial

BackgroundEarly identification of peripheral arterial disease (PAD) and subsequent instigation of risk modification strategies could minimise disease progression and reduce overall risk of cardiovascular (CV) mortality. However, the feasibility and value of primary care PAD screening is uncertain.AimThis study (the PIPETTE study — Peripheral arterial disease In Primary carE: Targeted screening and subsequenT managEment) aimed to determine the value of a proposed primary care PAD screening strategy. Outcomes assessed were: prevalence of PAD and agreement of ankle– brachial index (ABI)-defined PAD (ABI ≤0.9) with QRISK®2-defined high CV risk (≥20).Design and settingA cross-sectional observational study was undertaken in a large general practice in Merthyr Tydfil, Wales.MethodIn total, 1101 individuals with ≥2 pre-identified CV risk factors but no known CV disease or diabetes were invited to participate. Participants underwent ABI measurement and QRISK2 assessment, and completed Edinburgh Claudication Questionnaires.ResultsA total of 368 people participated in the study (participation rate: 33%). Prevalence of PAD was 3% (n = 12). The number needed to screen (NNS) to detect one new case of PAD was 31. Refining the study population to those aged ≥50 years with a smoking history reduced the NNS to 14, while still identifying 100% of PAD cases. Of participants with PAD, 33% reported severe lifestyle-limiting symptoms of intermittent claudication that warranted subsequent endovascular intervention, yet had not previously presented to their GP. The QRISK2 score predicted high CV risk in 92% of participants with PAD.ConclusionThe low PAD yield and the fact that QRISK2 was largely comparable to the ABI in predicting high CV risk suggests that routine PAD screening may be unwarranted. Instead, strategies to improve public awareness of PAD are needed.

scholarly journals Lower sensitivity of ankle-brachial index measurements among people suffering with diabetes-associated vascular disorders: A systematic review

2019 ◽  
Vol 7 ◽  
pp. 205031211983503 ◽  
Author(s):  
Ayman Abouhamda ◽  
Majid Alturkstani ◽  
Yousef Jan
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Systemic Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Lower Sensitivity ◽  
Index Measurement ◽  
Cardiovascular Morbidity And Mortality ◽  
Peripheral Arterial

Diabetes mellitus is a systemic disease affecting microvascular and macrovascular systems and is considered as the strongest risk factor for peripheral arterial disease. Although the prevalence of the peripheral arterial disease is high among people living with diabetes, its severity is not accurately detected with the prevalent diagnostic methodologies. The ankle-brachial index measurement is a simple, objective, and reliable tool for diagnosis of peripheral arterial disease. However, it is of limited value in the diagnosis of peripheral arterial disease among diabetic patients due to its low sensitivity among diabetic individuals. Diabetes mellitus results in atherosclerosis and calcification of peripheral arterial walls leading to false normal ankle-brachial index values. Therefore, healthcare practitioners should be careful not to misinterpret ankle-brachial index results among diabetic patients. A literature search was conducted using the keywords “ankle-brachial index,” “interpretation,” “limitations,” “diabetic foot,” and “peripheral arterial disease” on different medical search engines. The results were manually scanned and then further reviewed to select the articles related to our topic of discussion. This article will review the use of ankle-brachial index measurement among diabetic patients, its limitations and its prognostic value. In Conclusion, Ankle-brachial index can be used for diagnosis of peripheral arterial disease with some precautions (e.g. raising the threshold of diagnosis or using the lowest systolic pressure value measured at the ankle) and can also be a prognostic indicator for cardiovascular morbidity and mortality.

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