The ankle-brachial pressure index and a standardized questionnaire are easy and useful tools to detect peripheral arterial disease in non-claudicating patients at high risk.

AIM

This observational study (Survey of Peripheral Arterial Disease Epidemiology, SPADE) evaluated the prevalence of asymptomatic peripheral arterial disease (PAD) in general practice.

METHODS

PAD was determined as an ankle-brachial pressure index (ABI) <0.9 measured with Doppler ultrasound. Included patients had a history of ischemic events and/or risk factors for PAD, but no spontaneous complaints of intermittent claudication. Patients with an ABI <0.9 filled in a standardized questionnaire and their drug use was registered. A total of 4 536 patients was included.

RESULTS

The prevalence of PAD was 18.7% for the total population, 26.5% for those with a history of ischemic events and 15.2% for those without such history. The prevalence increased with age, but was independent of gender. A standard questionnaire revealed leg pain when walking uphill or when hurrying in 2/3 of patients with an ABI <0.9 and in 45% criteria for claudication were met.

CONCLUSION

ABI detects PAD in a considerable number of asymptomatic patients at increased risk and followed in general practice. When properly questioned almost half of these patients appear to have intermittent claudication.