2-6SCREENING FOR PERIPHERAL ARTERY DISEASE IN HYPERTENSIVE PATIENTS AT A PRIMARY HEALTH CARE CENTRE IN BONTANG, EAST BORNEO: A STUDY USING ANKLE BRACHIAL INDEX BY PALPATION METHOD

Abstract

Background: Hypertension is a significant risk factor for peripheral artery disease (PAD). Early identification and treatment of PAD could minimize disease progression and reduce cardiovascular mortality. Studies have validated ankle branchial index (ABI) by palpation as a simple and useful method for screening PAD in the setting of primary health care. Objective: To screen for PAD in hypertensive patients at a primary health care centre in Bontang, East Borneo. Methods: This was a cross-sectional study conducted in Puskesmas Bontang Utara II from August to September 2019. We did the screening of PAD in hypertensive patients aged ≥50 years using ABI by palpation method. PAD was defined as ABI <0.9 in either leg. Hypertension is defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medications. Patients with a history of diabetes mellitus, dyslipidemia, and smoking were excluded from this study. Results: A total of 139 hypertensive patients were included, 76 (54.7%) of them were female, with a mean age was 62.45 ± 8.92 years. There were 26 (18.7%) patients diagnosed with PAD, 7 (27%) of them were asymptomatic, and 19 (73%) were symptomatic. PAD was significantly higher in patients aged ≥65 years (OR = 7.51; p < 0.001) and in patients who have suffered hypertension more than five years (OR = 3.18; p = 0.023). Sex and hypertension stage did not show a significant association with PAD. Conclusion: PAD affected almost one-fifth of hypertensive patients in this study population. Screening of PAD in primary health care needs to be done for hypertensive patients aged ≥50 years, especially emphasized in patients aged ≥65 years and have suffered hypertension for more than 5 years.