[Determination of ankle-brachial index using a portable doppler and a blood pressure measuring device in diabetic patients]

Abstract

Peripheral arterial disease (PAD) is one of the systemic manifestations of atherothrombosis. The subjects with atherosclerosis in a particular vascular bed are at increased risk of cardiovascular and cerebrovascular complications. The diagnostic methods currently available in Primary Care (PC) for the diagnosis of PAD are pedal pulse palpation, oscillometry and Doppler. We designed a descriptive study to determine the prevalence of PAD in diabetic patients by calculating their ankle-brachial index (ABI) using portable Doppler HADECO SMARTDOP 30EX and OMRON automatic blood pressure by two previously trained investigators-examiners, a doctor and a nurse. It was also intended to compare the results obtained with both diagnostic methods and learn the predictive value of a vascular event with an abnormal ABI. The prevalences of PAD measured with portable Doppler and automatic sphygmomanometer were 29.3 (95% CI; 23.3 to 35.8) and 15.3 (95% CI; 10.2 to 20.5), respectively. The intraclass correlation coefficient (ICC) showed an acceptable match of results obtained with the ABI automatic blood pressure compared to Doppler technique. We found in our study that the history variables of PAD, age, duration of diabetes, and sex showed statistical significance with PAD. The correlation coefficients of both ABI measurement with the existence of a cardiovascular event proved to be significant for patients with levels below 0.9 with a chi-squared P<.05. Early detection of PAD in the clinic enables preventive strategies to be established and to intensify the treatment in these cases.