Prevalence of (A)Symptomatic Peripheral Arterial Disease; the Additional Value of Ankle–Brachial Index on Cardiovascular Risk Stratification

Abstract

The prevalence of peripheral arterial disease (PAD) in the general population varies between 7% and 21%. This is strongly related to age, gender and the definition of PAD, defined by the ankleebrachial index (ABI) cut-off and/or the presence of intermittent claudication (IC). PAD is typically asymptomatic before progressing to clinical stages such as IC or even critical limb ischaemia. The ABI, as a screening tool, has emerged as an accurate and reliable marker of (a)symptomatic PAD and as a measure of systemic atherosclerotic burden. The getABI study detected a PAD prevalence of 18% in the primary-care setting, while only 2.8% of the patients were symptomatic. In this issue of the Journal, Ramos et al. identified the prevalence of symptomatic and asymptomatic PAD in a population-based, cross-sectional study including 6262 participants aged 35e79 years. Furthermore, they evaluated the value of ABI measurement in addition to coronary heart disease (CHD) risk estimation. PAD, defined as an ABI< 0.9, was present in 4.5% of the study population, of which only 0.62% presented with IC assessed by the Edinburgh questionnaire. Prevalence increased up to 14% in