Ankle-brachial pressure index: An easy tool to detect diabetic's peripheral arterial disease

Cardiovascular disease, which includes coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD) is the leading cause of death worldwide. According to the epidemiologist, PAD is defined as an ankle-brachial pressure index (ABPI) less than 0.90. To assess the place of ABPI in diagnosing diabetic's PAD, 496 diabetic patients were examined prospectively by continuous Doppler. Through our study, we try to specify the importance of this easy tool in comparison with interrogatory and examination. We state its advantages and its limits. We find in our study that diabetic subjects with PAD have a very high risk of cardiovascular disease. Sensivity, specificity and easiness of ABPI plead for its systematic integration to the clinical approach of the patients with PAD's high risk as diabetics, elderly or smokers subjects. We promote its diffusion to general practitioners for or early diagnosis of PAD, more particularly in asymptomatic form in which prevention is the key to a successful management. Patient education efforts coupled with a team approach of aggressive early management represent the optimum current strategy to prevent both amputation and high mortality. © Ed. ESKA, 2007.