Abstract 1901: Prevalence of Peripheral Arterial Disease in General Practice using Ankle Brachial Pressure Index in High Risk Patients: the Ipsilon Study
Objectives: To determine the prevalence of Peripheral arterial disease (PAD) in high risk patients using Ankle Brachial Pressure Index (ABI) measurement by General Practitioners (GPs).
Methods: The Ipsilon study is a prospective, multicenter, cross-sectional study conducted in primary care GPs throughout France in May 2005-February 2006. Each GP was asked to include the first five patients who fulfil the following inclusion criteria: patients aged ≥ 55 years and presenting either with suspected PAD symptoms (group 1), history of atherothrombotic events (group 2) or CV risk factors only (group 3). Patients were evaluated by history, CV risk factors, physical examination, and measurement of ABI. Before starting the inclusion, each GP had to participate in two 45 minutes training sessions to learn the ABI technique and a third validation session. PAD was considered present if ABI < 0.9.
Results: A total of 5679 patients were included by 1219 GPs. Main characteristics, CV risk factors and ABI measurements of patients are summarized in Table 1⇓. The prevalence of PAD significantly increased (p<0.001), whatever the study group, with age, male gender (yes vs. no = 30.2% vs 23.5%), active smoking (38% vs 24.7%), absence of one pulse of the lower limb (53.2% vs 17.8%). In multivariate analysis, old age (Odd ratio, 0R=1.27), smoking (OR=1.97), diabetes (OR=1.33), hypertension (OR=1.21), intermittent claudication (OR=4.37) and history of atherothrombotic event (OR=3.53) were independently related to the presence of PAD.
Conclusion: PAD in high risk patients ≥ 55 years seen in primary care practice is highly prevalent and easily detected by a simple ABI measurement. Older age, lower limb claudication, active smoking, hypertension, diabetes and previous ischemic atherothrombotic event are independent factors associated to a low ABI.