[Early diagnosis of peripheral arterial disease by measuring the ankle-brachial index in patients of nursing consultations in primary health care]. / Detección precoz de enfermedad arterial periférica mediante la determinación del índice tobillo-brazo en atención primaria.

OBJECTIVE: The aim of this study was to detect peripheral arterial disease (PAD) by the measurement of the ankle-brachial index (ABI) in patients of nursing consultations in primary health care who presented a moderate or high risk in Framingham risk score. METHOD: This descriptive, cross-sectional and observational study included patients with a moderate or high risk in Framingham risk score, who went to programmed nursing consultations in a primary health care center in Elche during the period between March and April in 2009. A measurement of ankle-brachial index was performed. No patients were known to have arterial disease. RESULTS: ABI was measured in 52 patients. Mean age (standard deviation) of subjects was 66.5 (8.8) years and 51.9% were male. A low ABI (<0.9) was found in 13 patients. Therefore, PAD was diagnosed in 25% of the sample subjects. CONCLUSIONS: Nursing consultations in primary care are a right context to make an early diagnosis of PAD, by measuring ABI. This should be part of the exploration of chronic patients who come periodically to nursing consultations, particularly those ones with a moderate or high cardiovascular risk. In this way preventive measures could be intensified to prevent future cardiovascular complications in these patients.

Detección precoz de enfermedad arterial periférica. Mediante la determinación del índice tobillo-brazo en atención primaria / Early diagnosis of peripheral arterial. Disease by measuring the ankle-brachial index in patients of nursing consultations in primary health care

Objetivo. Detectar precozmente la enfermedad arterial periférica (EAP) mediante la medición del índice tobillo brazo (ITB) en usuarios de la consulta de enfermería de Atención Primaria (AP) con riesgo cardiovascular medio o alto calculado mediante la escala de Framingham. Método. Estudio descriptivo, observacional, transversal en el que se incluyó pacientes que acudieron a consulta de enfermería programada de un centro de salud de Elche durante el período comprendido entre marzo y abril de 2009 y que presentaban un riesgo cardiovascular medio o alto en la escala de Framingham. A los sujetos incluidos se les realizó la determinación del ITB. Se excluyó a los pacientes previamente diagnosticados de enfermedad coronaria, cerebrovascular o EAP. Resultados. Se midió el ITB en un total de 52 pacientes. La edad media (desviación estándar) de los sujetos fue de 66,5 (8,8) años y el 51,9% era varón. El ITB fue bajo (<0,9) en 13 pacientes. Por lo tanto se detectó EAP en un 25% de los usuarios a estudio. Conclusiones. La consulta de enfermería de AP constituye un contexto idóneo donde realizar la detección precoz de la EAP, mediante la determinación del ITB. Esta debería formar parte de la exploración de los pacientes crónicos que acuden periódicamente a consulta, sobre todo los que presentan un riesgo cardiovascular medio o alto. De este modo se podrían intensificar las medidas preventivas para evitar futuras complicaciones cardiovasculares en estos pacientes(AU)

Objective. The aim of this study was to detect peripheral arterial disease (PAD) by the measurement of the ankle-brachial index (ABI) in patients of nursing consultations in primary health care who presented a moderate or high risk in Framingham risk score. Method. This descriptive, cross-sectional and observational study included patients with a moderate or high risk in Framingham risk score, who went to programmed nursing consultations in a primary health care center in Elche during the period between March and April in 2009. A measurement of ankle-brachial index was performed. No patients were known to have arterial disease. Results. ABI was measured in 52 patients. Mean age (standard deviation) of subjects was 66,5 (8,8) years and 51,9% were male. A low ABI (<0.9) was found in 13 patients.Therefore, PAD was diagnosed in 25% of the sample subjects. Conclusions. Nursing consultations in primary care are a right context to make an early diagnosis of PAD, by measuring ABI. This should be part of the exploration of chronic patients who come periodically to nursing consultations, particularly those ones with a moderate or high cardiovascular risk. In this way, preventive measures could be intensified to prevent future cardiovascular complications in these patients(AU)