Ankle brachial index and its interpretation in diabetic patients
Authors:
O. Machaczka 1; J. Janoutová 1; M. Homza 2; V. Janout 1
Authors‘ workplace:
Ostravská Univerzita v Ostravě
Lékařská fakulta
Ústav epidemiologie a ochrany veřejného zdraví, Ostrava
Vedoucí: prof. MUDr. Vladimír Janout, CSc.
1; Fakultní nemocnice Ostrava
Kardiovaskulární oddělení
Primář: MUDr. Miroslav Homza, MBA
2
Published in:
Prakt. Lék. 2016; 96(3): 107-113
Category:
Of different specialties
Overview
Ankle brachial index measurement is a non-invasive technique that is widely used by many medical practitioners to determine the peripheral vascular diseases, especially lower extremity arterial disease (LEAD). The principle of this method is to determine the ratio of systolic blood pressure at the ankle and a systolic blood pressure on the arm. However, in diabetic patients may be decreased the sensitivity of ankle brachial index due to diabetic neuropathy and presence of medial artery calcification, which reduces the reliability of the results that precludes the accurate determination of systolic blood pressure in the leg. LEAD in general occurs in a higher percentage in patients with diabetes than non-diabetic population, in addition the presence of diabetes worsens the prognosis of patients with LEAD, which occurs at an earlier age and is faster. A larger proportion of patients with LEAD suffer of atypical symptoms or are asymptomatic in the initial stage, however during this period significantly increases the risk of developing cardiovascular disease, so it is important to detect the disease. Ankle brachial index is generally useful diagnostic method, which the most positive aspect lays in the simplicity of measurement and financial modesty. But it is questionable whether the specifics of the diabetic population are an obstacle to using this method, which criteria are valid for the general population, and whether it is appropriate to choose the ankle brachial index measurement as an initial examination of PAD even in diabetic patients. The simultaneous absence of uniform standards for the measurement and calculation ankle brachial index leads to inconsistent results, which can cause clinical and economic issues with a significant impact on public health.
Keywords:
ankle brachial index – diabetes mellitus – lower extremity arterial disease
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Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2016 Issue 3
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