Feasibility and reliability of ankle/arm blood pressure index in preventive medicine

Citation
A. Simon et al., Feasibility and reliability of ankle/arm blood pressure index in preventive medicine, ANGIOLOGY, 51(6), 2000, pp. 463-471
Citations number
29
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
ANGIOLOGY
ISSN journal
0003-3197 → ACNP
Volume
51
Issue
6
Year of publication
2000
Pages
463 - 471
Database
ISI
SICI code
0003-3197(200006)51:6<463:FAROAB>2.0.ZU;2-H
Abstract
Despite its potential usefulness for assessing preclinical atherosclerosis and cardiovascular risk, the ankle/arm blood pressure index (AAI) has not y et been the matter of study evaluating its feasibility and reliability by n onspecialist doctors in a general population. This study was planned for tw o steps. In step 1, the measurement of AAI, (ratio between Doppler systolic pressure at the ankle for each lower limb and the highest value of Doppler systolic pressure of the two upper limbs), should be performed by 50 gener al practitioners (GPs), 50 social security center physicians, and 50 occupa tional health physicians in 3,000 male smokers, 40 to 59 years, without cli nical cardiovascular disease. In step 2, AAI measurement, coupled with echo graphy-Doppler of iliofemoral arteries, should be repeated by a specialist in all subjects with decreased AAI (<0.90) and the first two subjects with normal AAI recruited in step 1 by each nonspecialist. The number of physici ans and subjects participating in step 1 was lower than planned (80 physici ans and 962 subjects) with the greatest defect for GPs (six physicians and 35 subjects) and the prevalence of decreased AAI was low (28 subjects). AAI measurement was repeated in step 2 in only 12 subjects with decreased AAI in step 1 and in 124 subjects with normal AAI in step 1. Five of the six su bjects with decreased AAI in step 2 also had decreased AAI in step 1 and 12 3 of the 130 subjects with normal AAI in step 2 also had normal AAI in step 1. As regards echographic stenosis, decreased AAI had a sensitivity of 44% and a specificity of 98%. AAI seems more feasible for occupational health physicians and social security center physicians and AAI is also reliable f or nonspecialists previously trained, but its predictive value as regards e chographic stenosis is poor in asymptomatic subjects, which may limit its u sefulness for detecting preclinical atherosclerosis.