[Usefulness of the ankle-arm index for detection of peripheral arterial disease in a working population of Junta de Andalucía at Málaga]. / Rentabilidad del índice tobillo-brazo para la detección de enfermedad arterial periférica en población laboral de la Junta de Andalucía en Málaga.

BACKGROUND AND OBJECTIVE: Detection of asymptomatic peripheral arterial disease increases the risk of vascular morbibity and mortality. We aimed to estimate the prevalence of clinical and subclinical peripheral arterial disease using the ankle-arm index (AAI) as diagnostic tool in a working population. SUBJECTS AND METHOD: We included 450 workers, older than 50 years old, attending voluntary regular health check-up at Centro de Prevención de Riesgos Laborales de la Junta de Andalucía in Málaga (Spain). We recorded clinical and anthopometrical data. Blood samples were taken after an overnight fast. Vascular risk was calculated using Framinghan and SCORE scales. Every participant was asked for symptoms of intermittent claudicatio and AAI was measured. AAI was considered normal within 0.9-1.3 values. RESULTS: Most of our workers were at low- or moderate vascular risk. Only 48 (10.6%) of individuals had an abnormal AAI: 9 (2%) showed an AAI<0.9 and 39 (8.6%) showed an AAI>1.3. An AAI<0.9 was found in 19% of those with a SCORE risk > or = 5%, and in 11% of those having a Framinghan risk > or = 20%. Intermittent claudication was present in 4 out of 9 (44%) of those having an AAI<0.9 and in 7 out of 402 (1.7%) with a normal AAI. CONCLUSIONS: Systematic screening of peripheral arterial disease using the AAI is not recommended in active working population over 50 years-old of age. Thus, AAI measurement is indicated only for those individuals suffering from intermitent claudicatio and those who are at moderate- or high vascular risk.

Rentabilidad del Índice tobillo-brazo para la detección de enfermedad arterial periférica en población laboral de la Junta de Andalucía en Málaga / Usefulness of the ankle-arm index for detection of peripheral arterial disease in a working population of Junta de Andaluc¨ªa at M¨¢laga

Fundamento y objetivola detecci¨®n de arteriopat¨ªa perif¨¦rica silente mediante el ¨ªndice tobillo-brazo (ITB) incrementa el riesgo de enfermedad y muerte vasculares. Nuestro objetivo ha sido conocer la prevalencia de enfermedad arterial perif¨¦rica mediante la cuantificaci¨®n del ITB en poblaci¨®n laboral.Sujetos y m¨¦todose incluy¨® a 450 trabajadores mayores de 50 años que acudieron voluntariamente a reconocimiento peri¨®dico en el Centro de Prevenci¨®n de Riesgos Laborales de la Junta de Andaluc¨ªa en M¨¢laga. Se anotaron los antecedentes cl¨ªnicos y los datos de la antropometr¨ªa, se tom¨® una muestra de sangre tras ayunas de 12h y se estim¨® el riesgo vascular global. Se interrog¨® a todos los participantes acerca de la presencia de claudicaci¨®n intermitente y se les cuantific¨® el ITB. Se consider¨® normal un ITB entre 0,9 y 1,3.Resultadosla mayor parte de los participantes tuvo un riesgo vascular bajo o moderado. S¨®lo 48 (10,6%) presentaban un ITB anormal: en 9 (2,0%) era inferior a 0,9 y en 39 (8,6%) superior a 1,30. El ITB era menor de 0,9 en el 19% de los sujetos con un riesgo SCORE del 5% o superior y en el 11% de aqu¨¦llos con un riesgo Framingham igual o mayor del 20%. Presentaban claudicaci¨®n intermitente 4 de los 9 sujetos (44%) con ITB inferior a 0,9 y 7 (1,7%) de los 402 con ITB normal.Conclusionesno est¨¢ justificado el cribado sistem¨¢tico de la enfermedad arterial perif¨¦rica mediante la determinaci¨®n del ITB en poblaci¨®n laboral mayor de 50 años, debiendo reservar esta exploraci¨®n ¨²nicamente para pacientes con claudicaci¨®n o riesgo vascular moderado o alto

Background and objectiveDetection of asymptomatic peripheral arterial disease increases the risk of vascular morbibity and mortality. We aimed to estimate the prevalence of clinical and subclinical peripheral arterial disease using the ankle-arm index (AAI) as diagnostic tool in a working population.Subjects and methodWe included 450 workers, older than 50 years old, attending voluntary regular health check-up at Centro de Prevenci¨®n de Riesgos Laborales de la Junta de Andaluc¨ªa in M¨¢laga (Spain). We recorded clinical and anthopometrical data. Blood samples were taken after an overnight fast. Vascular risk was calculated using Framinghan and SCORE scales. Every participant was asked for symptoms of intermittent claudicatio and AAI was measured. AAI was considered normal within 0.9¨C1.3 values.ResultsMost of our workers were at low- or moderate vascular risk. Only 48 (10.6%) of individuals had an abnormal AAI: 9 (2%) showed an AAI<0.9 and 39 (8.6%) showed an AAI>1.3. An AAI<0.9 was found in 19% of those with a SCORE risk ¡Ý5%, and in 11% of those having a Framinghan risk ¡Ý20%. Intermittent claudication was present in 4 out of 9 (44%) of those having an AAI<0.9 and in 7 out of 402 (1.7%) with a normal AAI.ConclusionsSystematic screening of peripheral arterial disease using the AAI is not recommended in active working population over 50 years-old of age. Thus, AAI measurement is indicated only for those individuals suffering from intermitent claudicatio and those who are at moderate- or high vascular risk