Abstract
Introduction: Hypertension is one of the leading causes of global burden of disease. In a study, prevalence of hypertension in India was quoted 13.1% and only 16.7% of the person had achieved BP control of 140/90mm Hg. Peripheral vascular disease (PVD) is a slow and progressive circulation disorder which is characterized by narrowing of the vessels that carry blood to the leg and arm muscles. It is estimated that PAD affects 2 billion people worldwide. It is also estimated that of all the hypertensives at presentation, 2-5% have claudication. Similarly 50-92% of patients with PAD have hypertension. The Ankle-brachial Index (ABI) is the ratio of the systolic blood pressures between the dorsalis pedis and the posterior tibial artery to the higher of the systolic blood pressures in the two brachial arteries. The ABIs sensitivity is 90% and its specificity is 98%. Normal ABI range of 1.00 to 1.40.The patient is diagnosed with PAD when the ABI is ? 0.90, ABI Acts as an independent predictor of coronary and cardiovascular morbidity and mortality.Materials and methods: In this study 100 patients were registered who were suffering from hypertension, which include both indoor and outdoor patients, were studied. These patients were between the age group 45-75 years. In this study 82 were males and 18 were females. .Patients with history of Diabetes, Smoking, Hyperlipidemia, and with other risk factors excluding hypertension were excluded from the study. Ankle Brachial Index (ABI) was measured for the patients. A Doppler ultrasound blood flow detector and a sphygmomanometer (blood pressure cuff) was used to measure ABI. The patient is diagnosed with PAD when the ABI is ? 0.90Observation: Total number of patients 100. Prevalence rate of peripheral arterial disease in hypertensive patients with age group (45-75) was 7%. The highest prevalence rate was seen in patients in age group 65-75 years. Males had slightly higher prevalence of peripheral arterial disease than females. Prevalence of ECG abnormalities suggesting cardiovascular disease was higher in patients with peripheral arterial disease than patients without peripheral arterial disease. Abnormal ABI (<0.9) was found in significantly higher proportion of patients with clinical evidence of peripheral arterial disease (86%) than in patients without clinical evidence of peripheral arterial disease (1.1%).Conclusion: The present study shows that ABI is a valuable method for the diagnosis of peripheral arterial disease in patients of Hypertension and should be applied in routine practices which may improve cardiovascular risk predictionBangladesh Journal of Medical Science Vol.15(4) 2016 p.556-564
Highlights
Hypertension is one of the leading causes of global burden of disease
Normal Ankle-brachial Index (ABI) range of 1.00 to 1.40.The patient is diagnosed with peripheral arterial disease (PAD) when the ABI is ≤ 0.90
One of the study which was taken by Kennedy M, Solomon C et al 2005 on risk factor for declining ankle brachial index in men and women 65 years or older, in which significant number of patients with peripheral arterial diseased were in advancing age[26]
Summary
Hypertension is one of the leading causes of global burden of disease. It is common, asymptomatic, readily detectable usually treatable and often leads to lethal complications if left untreated. Several previous studies have clearly shown longitudinal associations between HTN and coronary artery disease, myocardial infarction, stroke, congestive heart failure, and peripheral vascular disease and lowering blood pressure (BP) significantly reduces the cardiovascular morbidity and mortality[3]. Grade IV, Category 6: Major tissue loss; Severe ischemic ulcers or frank gangrene Risk factors contributing to PAD are the same as those for atherosclerosis[10]. Hypertension is a common and important risk factor for vascular disorder, including PVD of hypertensives at presentation, about 2-5% has intermittent claudication, and this prevalence increases with age. Lower blood pressure in the leg is an indication of blocked arteries (peripheral vascular disease or PVD). Patient in this study were first evaluated by complete history including age, smoking history, diabetes, history of symptoms of peripheral arterial disease including ,Intermittent claudication, resting extremity pain. Method: The patient was placed supine, without Observation: the head or any extremities dangling over the edge of 7DEOHQR*HQGHUVSHFLILFSUHYDOHQFHRISHULSKHUDODUWHULDOGLVHDVHLQK\SHU the table as measurement of WHQVLYHSDWLHQWVEHWZHHQWKHDJHV\HDUV ankle blood pressures in a seated position will grossly overestimate the ABI
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