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Introduction. Chronic mesenteric ischemia is a rare entity, with a prevalence of 0.03%, where more than 90% are due to arteriosclerotic disease that mainly affects the superior mesenteric artery. Its symptoms are chronic abdominal pain and weight loss, associated with imaging alterations that make the diagnosis. Treatment depends on the patient's clinical conditions and the number of vessels involved. It is clear that symptomatic multivessel disease requires revascularization. Clinical case. A 67-year-old woman, an active smoker with a history of high blood pressure and dyslipidemia, presented with an emergency-type hypertensive crisis that required management in the Intensive Care Unit. A diagnosis of Crawford IV thoracoabdominal aneurysm, aorto-iliac occlusion (TASC D), and chronic occlusion of the celiac trunk and superior mesenteric artery was made. Due to the symptoms of chronic mesenteric ischemia, she underwent surgical treatment with aorto-bifemoral bypass plus retrograde bypass to the superior mesenteric artery via an open approach. Result. The patient had improvement in symptoms and gained 13% weight at 3-month follow-up. Conclusion. Chronic mesenteric ischemia is an underdiagnosed condition, a marker of cardiovascular risk, with a high burden of morbidity and mortality, in which, with early identification, revascularization therapy can be offered, either endovascularly or open, in order to improve quality of life and weight gain, and avoiding intestinal necrosis. [ABSTRACT FROM AUTHOR]

The relationship between the Ankle Brachial Index (ABI) with the sociodemographic and clinical factors of patients with Type 2 Diabetes Mellitus (DM2) was identified. A descriptive correlational study was conducted with a sample of 91 participants. A personal/ clinical data card was used, collected by nurses who followed national and international recommendations for the evaluation of clinical variables. The ABI was correlated with age, diastolic and systolic blood pressure. There was a correlation between other clinical and sociodemographic variables. Nursing can identify risk factors for Peripheral Arterial Disease in patients with DM2 and contribute both to the improvement of clinical characteristics and to the use of appropriate footwear that favors quality of life and damage limitation in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Intermittent claudication is a life-threatening and limb-threatening condition that constitutes a current health problem. It is very common nowadays and is associated with the presence of some risk factors. Supervised physical exercises are indicated for the treatment of these patients. Supervised cardiovascular rehabilitation (CVR) can be an effective therapy for these patients. Objective: To evaluate the effects of supervised cardiovascular rehabilitation on some risk factors in patients with intermittent claudication. Method: A quasi-experimental, comparative, intervention study was carried out with patients diagnosed with intermittent claudication referred to the department of cardiovascular rehabilitation of the Hospital Clínico Quirúrgico Hermanos Ameijeiras between January and December 2017. The sample consisted of two groups: group A, that included 47 patients who underwent supervised rehabilitation and group B, that included 59 cases who underwent outpatient physical therapy. Results: Supervised CVR significantly decreased body mass index (32.8 Kg/m² vs. 29.6 Kg/m² ), values of fibrinogen (349 vs. 294 mg/dL), C-reactive protein (4.8 vs. 2.8 mg/L), glycemia (7.5 vs. 5.6 mmol/L), glycosylated hemoglobin (6.6 vs. 5.6%), total cholesterol (6.3 vs. 4.7 mmol/l) and triglycerides (2.6 vs. 1.4 mmol/l, p<0.001) and increased hemoglobin (12.1 vs. 13.2 g/mL) and HDL cholesterol (0.8 vs. 1.4 mmol/L), p<0.001. Conclusions: Supervised cardiovascular rehabilitation showed a favorable effect on risk factors in patients with intermittent claudication [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is the chronic disease of more morbidity worldwide, which represents a health problem due to its multicausality and consequences. Objective: To describe the main sociodemographic and clinical characteristics of patients with hypertension, belonging to a health area of Niquero. Methods: An observational, descriptive and cross-sectional study of 370 patients with hypertension who belonged to the Family Doctor Office No. 4 of Niquero, Granma province, was carried out from June, 2021 to the same month in 2022. The variables age, sex, color of the skin, classification according to tension figures and evolution were studied, as well as patient state and complications. Results: There was a prevalence of the 40-59 (37.6 %) and 60-79 (36.5 %) age groups, female sex (58.4 %), as well as the mixed race color of the skin (55.9 %). The patients with grade II hypertension in phase 1 (44.3 %) and partially compensated (55.9 %) were the majority. Peripheral arterial disease was the main complication (21.1 %). Conclusions: The description of the sociodemographic and clinical characteristics of patients with hypertension constitutes an element to take into account for the appropriate control of those affected in the health areas. [ABSTRACT FROM AUTHOR]

Introduction: The diabetes mellitus is the chronic disease considered as one of the highest sanitary emergencies in the XXI century in the world that can trigger some complications and serious health problems. Objective: To characterize diabetic patients with arterial chronic disease in lower limbs according to clinical, hemodynamic and ultrasound variables. Methods: An observational, descriptive and cross-sectional study of the 178 diabetic patients with clinical diagnosis of arterial chronic disease in lower limbs was carried out, who were assisted in the Imaging Service of Dr. Juan Bruno Zayas Alfonso General Hospital in Santiago de Cuba from January, 2017 to December, 2019, to whom hemodynamic exam by means of the ankle-brachial index and arterial Doppler ultrasound was carried out. Results: In the investigation there was a prevalence of the elderly (41.6 %) from the female sex (54.0 %), the intermittent abandonment as main symptom (57.3 %), the femoropopliteal sector (34.8 %) according to the exact topography of the lesions, as well as the significant stenosis (53.9 %) and the moderate peripheral arterial disease (58.3 %). Conclusions: Most of the patients presented a significant stenosis according to Doppler ultrasound, in correspondence with the diagnosis of moderated peripheralarterial disease by the ankle-brachial index. The Doppler ultrasound also contributed the exact topography of the lesions. [ABSTRACT FROM AUTHOR]

Aortoiliac occlusive disease, also known as Leriche´s Syndrome, is the occlusion of the abdominal aorta in its infrarenal segment, with atherosclerosis being the main cause. The most frequent risk factors are: hypertension, diabetes mellitus, dyslipidemia and smoking. The case of a patient with risk factors for atherosclerotic disease who was admitted due to pain in the lower limbs, intermittent claudication, discoloration of the foot and absence of pulses in the lower limbs is described. Clinically, is characterized by the classic triad: Claudication, erectile dysfunction and decreased distal pulses. Due to their chronicity, many are usually asymptomatic due to the collateral circulation they develop, which leads to underreporting. Vascular studies such as: Doppler ultrasound, computed tomography angiography and aortic angiography can help confirm the diagnosis and location of stenosis, always having clinical suspicion as a fundamental pillar. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the proportion of evidence of neuropathy and peripheral arterial disease, and to identify its relationship with sociodemographic variables, lifestyle and clinical factors with the classification of risk related to the foot of people with Diabetes Mellitus. Methods: Cross-sectional, descriptive, quantitative study. Sample for convenience 60 people in three Basic Health Units. It was used a sociodemographic form, clinical form for the assessment and screening of neuropathic pain, loss of protective sensitivity and peripheral arterial disease in primary care, a questionnaire for evidence of diabetic neuropathy. Pearson's test was applied in the relationship study. Results: Female predominance, mean age 58.1 (± 12.6) years, diagnosis time 12 years (± 9.6) and casual blood glucose 211.3mg/dl (± 91.7). Five participants presented evidence for neuropathy and none presented evidence for peripheral arterial disease. Significant correlation between risk classification, scores for neuropathic impairment (p <0.05) and monofilament (p <0.002). Conclusion: There was a low proportion of neuropathy and peripheral arterial disease, neuropathic impairment score and sensitivity to monofilament, were associated with risk classification. These relationships represent the need for intervention through the practice of screening for complications, which may contribute to the prevention of diabetic foot with amputation. [ABSTRACT FROM AUTHOR]

Introduction: Sarcopenia is characterized by loss of strength and muscle mass. Patients with diabetes mellitus who are under hemodialysis treatment show decreased physical activity and changes in their food intake, which also leads to the presence of sarcopenia. On the other hand, peripheral neuropathy and peripheral arterial disease commonly appear as chronic complications of diabetes mellitus. Methods: A cross-sectional, observational study was carried out in diabetes mellitus patients on hemodialysis. For the assessment of sarcopenia, muscle strength, physical performance and muscle mass percentage were measured. Muscle strength was calculated with a dynamometer, while physical performance was evaluated in seconds by means of a walk test with a stopwatch; muscle mass percentage was obtained using a scale with bioelectrical impedance. Sarcopenia was considered severe when there was low muscle strength and percentage in addition to low physical performance. Peripheral neuropathy was assessed by exploring touch and pressure sensibility with the Semmes-Weinstein monofilament test and deep sensibility with a 128 Hz tuning fork. The ankle-brachial index was the measurement taken for the peripheral arterial disease classification. Results: The final analysis was performed with 33 patients, whose time on hemodialysis was 3.57 ± 2.56 years. The prevalence of severe sarcopenia and sarcopenia was 90.8% and that of pre-sarcopenia was 9% of all patients. On the other hand, 78.1% were found to be patients with loss of deep sensibility, while the percentage of patients with loss of sensibility to pressure and touch was 54.5%. A correlation was found between the sarcopenia parameters and the time of evolution of renal failure and age. Conclusion: Sarcopenia occurs, in its different stages, in practically all diabetes mellitus patients undergoing hemodialysis; there is a relationship with the patient's age and hemodialysis time. [ABSTRACT FROM AUTHOR]

Introduction: Peripheral artery disease (PAD) may present with no symptoms at all, hence the need for diagnosis to avoid complications. Objective: To determine the presence of peripheral artery disease by means of the ankle-brachial index obtained by photoplethysmography in prehypertensive patients. Method: A descriptive cross-sectional study was carried out in a population of 35 patients over 18 years of age, with a presumptive diagnosis of prehypertension, belonging to the Family Doctor's Office 2 from the Policlínico Universitario Josué País García in Santiago de Cuba. The ANGIODIN® PD 3000 digital plethysmograph was used to measure the ankle-brachial index. Results: None of the patients had symptoms of PAD, but after measuring the anklebrachial index, 51.43% of them were found to have signs of this disease. Peripheral artery disease was more frequent in men (52.94 vs. 50.0%), with no significant statistical differences (p>0.05). Conclusions: The ankle-brachial index obtained by photoplethysmography was useful in determining the presence of asymptomatic peripheral artery disease in prehypertensive patients. A high incidence of the disease was identified, with a higher frequency in the male sex. [ABSTRACT FROM AUTHOR]

Peripheral obstructive arterial disease is a clinical entity closely related to frequent pathologies in our environment, which if not identified and treated early can cause serious complications including the development of chronic ulcers, intermittent claudication and amputation. The measurement of the ankle-brachial index by portable Doppler ultrasound is a non-invasive, fast, simple, reliable technique of great interest that offers high sensitivity and specificity to diagnose this disease. Objectives: the present study aims to determine the prevalence of peripheral obstructive arterial disease as determined by the ankle-brachial index in adults over 60 years of age attending the Capacachi Health Center, from October 1 to December 31, 2020. Methods: a descriptive, cross-sectional and prospective study was carried out; the ankle-brachial index was calculated in 176 patients over 60 years of age; patients with deep and/or superficial venous thrombosis, phlebitis, lymphangitis, with open wounds in the area where the echo-Doppler transducer was placed, who had undergone peripheral arterial revascularization or patients taking anticoagulants or antiplatelet agents were excluded. Results: of the 176 patients studied, 73 patients had an ankle-brachial index <0.9 and therefore had the disease. The prevalence of peripheral obstructive arterial disease was 41.48%. Conclusions: the study established that the ankle-brachial index is useful as a screening method to diagnose peripheral obstructive arterial disease in primary care centers, allowing us to perform secondary prevention at a low cost and in a bloodless manner. [ABSTRACT FROM AUTHOR]

Introduction: The coexistence of peripheral artery disease in patients with acute coronary syndrome affects health-related quality of life. Cardiac rehabilitation is an effective tool for the treatment of both diseases. Objective: To assess health-related quality of life according to the EQ-5D questionnaire before and after rehabilitation. Method: A total of 484 patients discharged from the coronary care unit with a diagnosis of acute coronary syndrome were studied. They were diagnosed with peripheral artery disease by ankle-brachial index test and started cardiac rehabilitation from March the 1st, 2011 to February the 30th, 2018. Their quality of life was assessed using the EQ-5D questionnaire before and after rehabilitation. The Pearson correlation coefficient was employed for quantitative variables and the Wilcoxon nonparametric test was utilized to contrast the hypothesis of equality between two population medians in ordinal and interval variables. Results: The dimensions assessed by the EQ-5D quality of life questionnaire show a positive correlation between pain-free walking distance and exercise time with the results of the EQ-5D score, thus demonstrating the benefits of rehabilitation. Conclusions: Cardiac rehabilitation improved the quality of life of patients with peripheral artery disease and acute coronary syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Peripheral arterial disease is a systemic vascular atherosclerotic disease that results from lumen narrowing causing a decrease in blood flow to the lower limbs. Its diagnosis can be made through noninvasive tests, such as the ankle-arm index. Objective: To evaluate the cases of peripheral arterial disease in the region of Proença-a-Nova by performing the ankle-arm index, taking into account the risk factors. Methodology: 55 individuals were studied, of which 27 individuals (49.1%) were male and 28 (50.9%) female, with ages ranging from 45 to 89 years and average of 64 ± 9.94 years. Results: Regarding risk factors, most do not exercise regularly (69.1%), coinciding with the absence of intermittent claudication (69.1%). The most present risk factor was hypertension (52.7%). Regarding the ankle-arm index, most have values within the normal range and 12 with mild peripheral arterial disease. There were no cases of moderate or severe disease. Conclusion: In this sample there is a higher percentage of cases with mild peripheral arterial disease in individuals who do not engage in regular physical activity, former smokers, diabetics, dyslipidemics and those with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a systemic disease that affects a number of vascular beds. Clin ical manifestations whether acute or chronic (acute myocardial infarction, stable angina, intermittent claudication, cerebrovascular disease, among others) start after long periods of progression; so it may present subclinically in patients with coronary ar tery disease. What is particularly interesting about this form of prese ntation is that within a series of cases with multivessel disease, associated with an ankle-brachial index (ABI)<0.9, after an acute coronary syndrome, we have ident ified, as an angiogr aphic finding, the presence of a coronary artery fistula to the right ventricle in a patient with very low ABI and clinical intermittent claudication. This fistula led to the symptoms that hampered cardiovascular rehabilitation. It is an infrequent disease characterized by chest pain; with low reporting (0.3 to 0.8%), as an incidental finding in coronary angiographies. [ABSTRACT FROM AUTHOR]

Leriche's syndrome is an occlusive vasculopathy that progressively affects the abdominal aorta and the common iliacs. This paper reports the case of a female patient with various vascular risk factors, which presented a clinical picture compatible with vascular occlusion (claudication). The characteristics of a Leriche's syndrome were confirmed by imaging. The patient finally died. Incidence and prevalence of Leriche's syndrome are unknown, cases in the female gender are the main ones in autoimmune diseases. For the diagnosis, an adequate clinical history is required and confirmed by imaging studies. The treatment is aimed at preventing the progress of the disease. Within the pharmacological management are some vasodilators, antiplatelet agents and statins. Surgical management can be an open or endovascular surgery, the first one offers the greatest benefit, despite the risks involved. [ABSTRACT FROM AUTHOR]

Aim: Evaluate the characteristics of patients undergoing angioplasty in the lower limbs, as well as to establish possible associations between the factors leading to complications. Materials and Method: Observational descriptive, cross-sectional and retrospective study conducted during 18 months in which patients with peripheral arterial disease undergoing angioplasty of the lower limb were included, as well their demographic, clinical, and surgical characteristics and the postoperative complications. Results: 158 records of patients between 30 and 95 years were evaluated. 65.2% (n = 103) of the procedures were performed not urgently, the most frequently intervened vessels were the superficial femoral artery (64%), the most frequent type of endovascular intervention was the combination of balloon + medicated ball (32.9%), the most used postoperative pharmacological treatment was the combination of acetylsalicylic acid (ASA) and clopidogrel (86.1%). There were 21 cases of complications, the most frequent complication was minor amputation (52%). A higher risk of minor amputation was found when the surgical procedure was performed urgently (p = 0.012, OR [95% CI]: 4.8 [1.4-16.5]). Discusion: The post-angioplasty complication with statistically significant difference was minor amputation when the procedure was performed urgently, this association was related to the clinical status of the patient at the time of admission and not to the surgical procedure. Conclusion: Angioplasty performed urgently is as safe as elective procedures, given by the same proportion of bleeding or arterial dissection. [ABSTRACT FROM AUTHOR]

Objective: Describe the clinical and imaging characteristics of diabetic patients who underwent endovascular treatment for peripheral arterial disease. Method: A retrospective descriptive study was carried out. We reviewed the data in the clinical and radiological file of the patients included in the study; they were collected in a survey sheet previously authorized by the Bioethics Committee of the Institution. The data obtained were tabulated in the Epilnfo v7.2 program and graphed using the Office Excel 2016 program. Results: Fifty patients who met the inclusion criteria were included in the study, 52% of them were women, mainly in the age group between 61-70 years. Arterial hypertension was the most frequent comorbidity in the study population with 78% of the total patients. Arterial disease below the knee was more frequent, with involvement of the anterior tibial artery in 84% of the patients evaluated. Balloon angioplasty was performed in 100% of the cases, while stent placement was necessary in 10% of the procedures performed. The result of the procedure was not successful only in 4/50 patients performed. 84% of the patients presented primary patency at 6 months of evaluation. Conclusion: Peripheral arterial disease mainly the vessels of the leg below the knee. Endovascular treatment of peripheral arterial injuries is a safe method with a high success rate in the initial procedure, as well as a low recurrence of intervention at least 6 months after the procedure. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy and reliability of the neurological test (NT) and the arterial test (AT) according to the International Working Group on the Diabetic Foot (IWGDF) guidelines in the diagnosis of diabetic peripheral neuropathy (DPN) and peripheral arterial disease (PAD), respectively, using variables such as sensitivity (Se), specificity (Sp), positive predictive value (PPV), and positive likelihood ratio (PLR) in type 2 diabetic patients attending the primary health care. Materials and methods: One hundred (100) type 2 diabetic patients were chosen from the public primary health care system, and evaluated by a primary physician in a private diabetic foot unit. The NT was represented by the tactilevibratory sensitivity and the AT by the ankle-brachial index according to the IWGDF guidelines. They were compared to standard neurological and arterial tests called Michigan Neuropathy Screening Instrument and Duplex Doppler Ultrasound, respectively, and performed by a diabetic foot specialist. Results: The NT showed an Se and Sp of 100 % and 94 % for the DPN, and the AT showed an S and E of 67.3 % and 83.2 % for the PAD, as well as a high PPV. The PLR was good in the NT, but poor in the AT. Conclusions: Accuracy and reliability of the NT and AT according to the IWGDF guidelines were adequate to diagnose DPN and PAD, respectively, in type 2 diabetic patients attending the primary health care, whose values were very similar to other studies' but affected by local factors. [ABSTRACT FROM AUTHOR]

We present the case of a 51-year-old woman who received multiple radiotherapy sessions for cervical cancer, after which she had several complications including non-healing wounds and chronic pain in the right leg diagnosed as neuropathic. We describe ways to diagnose vascular disease and the treatment with revascularization, in this case, with extra anatomic bypass. [ABSTRACT FROM AUTHOR]

Introduction: The ankle-brachial index provides a simple method to diagnose peripheral artery disease; its use allows identifying patients with intermittent claudication of the lower limbs who do not successfully complete a cardiovascular stress test, which hinders their inclusion in rehabilitation programs. Objective: To design a comprehensive rehabilitation program for patients with peripheral artery disease and ischemic heart disease. Method: An observational, descriptive, prospective and longitudinal study was carried out with 28 patients after an acute coronary syndrome and peripheral artery disease. A training program was designed and after a three months follow up results were compared with those at the beginning of the investigation. Results: Male predominance (67.8%), 17 of them (60.7%) had an ankle-brachial index less than 0.9 (p=0.002). The most affected age group was 55-59 years (35.7%). The primary diagnosis was acute coronary syndrome with ST segment elevation (42.85%). The most common risk factor was hypertriglyceridemia (82.1%). Smoking (75%; p=0.005) and diabetes mellitus (28.6%; p=0.001) were significantly associated with a ITB=0,9. After three months of supervised physical activity, the ankle-brachial index improved and increased time on exercise (4:21 vs. 10:9 minutes) and onset of pain (2:31 vs. 7:6 minutes). ** Conclusions: The introduction of supervised training programs for peripheral artery disease improves functional capacity of patients and their comprehensive evaluation, which favors joining cardiovascular rehabilitation programs. [ABSTRACT FROM AUTHOR]

The peripheral arterial disease, as well as the coronary and cerebrovascular disease are the result of development of the atherotrombotic disease and therefore constitute an important health problem all over the world, as the main causes of morbi- mortality and discapacity in elderly. Intermittent claudication in the lower limbs is the most common clinical presentation. Many patients are aymptomatic so that this process is often underdiagnosed and undertreated. Diagnostics and treatment, are important since the peripheral artery disease is associated with increased mortality. Determining of the ankle-brachial index is especially useful as allows early diagnosis of peripheral artery disease. Expert guidelines consider antiplatelet agents as the first line drugs, mantaining aspirin as first option. In intolerancy, allergic or resistant cases, clopidogrel is indicated. The present review summarizes the peripheral artery disease physiophatology, sintomatology and clinical classification. Discusion of risk factors remarks its control as a clue measure in prevention strategy. It is also discused the appropiate diagnosis and pharmacological treatment for management. It is concluded that the best way to reduce the peripheral artery disease mortality and morbidity in elderly is based on prevention, risk factors control, healthy life style and suitable therapeutic management [ABSTRACT FROM AUTHOR]

An observational and descriptive study of case series was conducted in 14 patients with aortoiliac peripheral artery disease, operated through direct vascular procedures at the Department of Angiology and Vascular Surgery of "Saturnino Lora Torres" Provincial Teaching Clinical Surgical Hospital in Santiago de Cuba, from January 2010 to October 2012, to characterize them according to some clinical and surgical parameters and evaluate the effectiveness of the surgical treatment. Among the main results it was obtained that the total number were men over 50 years of age in whom the Doppler ultrasound was selected as imaging technique; all patients with occlusions were smokers and 50% of them underwent bypass surgery, whereas all patients with aneurysms had hypertension and 62.5% of them underwent vascular replacement surgery. It was concluded that occlusive aortoiliac peripheral artery disease has an increasingly early onset, abdominal aortic aneurysms are not diagnosed early, and angiography and CT studies are needed to decide the surgical treatment, and surgical parameters such as time of aortic clamping, diuresis during clamping, urine output and surgical time had no serious implications in the postoperative period or survival of patients. [ABSTRACT FROM AUTHOR]

Objectives: Determine inter and intra observer variability of the ankle-brachial index measured by palpation using a standardized method (ITBp), and to correlate it with pulse palpation. Methods: 25 patients with risk factors for developing peripheral arterial disease were included in the study. Each observer performed 4 measurements of the ITBp as well as palpation of the peripheral pulse. Intra observer variability was tested with the student's t-test, and inter observer variability was tested with multivariate analysis of variance. Kappa statistics was used to determine the inter observer concordance of peripheral pulse palpation. Results: 64% of patients were male; mean age was 59.28 ± 10.6; 32% had diabetes mellitus, and 44% had hypertension. Kappa indexes for brachial and dorsalis pedis pulse were 1 and 0.8, respectively. Kappa indexes for posterior tibialis pulse measured by interns and attending physicians was 0.42 and 0.45, respectively. More experienced physicians had lesser overall differences in the intra observer measurements. No difference was observed in the inter observer measurements. Conclusions: Good inter observer correlation to measure ITBp was observed; indicating that using a standardized method reduces variability. A significant intra observer variability of 25% was observed. [ABSTRACT FROM AUTHOR]

Background: Patients with altered ankle-arm index have risk of cardiovascular events in the next 10 years (cerebral or cardiac infarction). It is known that the glycosylated hemoglobin and each of the components of the metabolic syndrome increases the cardiovascular risk. Material and methods: We performed a cross-sectional, multicenter, population-based study in 105 individuals with metabolic syndrome recently diagnosis in four primary care centers in Mexico City. The cardiovascular risk was evaluated using ankle-arm index. results: We studied 105 patients. The linear correlation analysis showed simple factor of increased risk (odds ratio [OR] 3.9 [95% CI: 1.05 -14.31]) with glycosylated hemoglobin < 6.5 % and with ankle-arm index < 0.9. When the glycosylated hemoglobin was > 6.5 or 7 there was no statistically significant difference. Correlation of the mean arterial pressure (MAP) with the ankle-arm index: OR 7.2 for mean arterial blood pressure > 88 mm Hg OR: 5.6 (95% CI: 1.43 - 23.45) and with mean arterial pressure > 100 mm Hg. Conclusions: Cardiovascular risk increases if the glycosylated hemoglobin is less than 6.5 %, or if the mean arterial pressure is greater than 88 mm Hg, in patients with newly diagnosed metabolic syndrome. [ABSTRACT FROM AUTHOR]

Objective: to know the peripheral arterial disease (PAD) prevalence and its determinants in a nationwide survey in Mexican population. Methods: baseline ankle brachial index (ABI) measured by Doppler was performed in patients at high vascular risk for PAD. ABI between 1 and 1.3 was regarded as normal. ABI = 0.9 (a low ABI) was considered to be an indicator of PAD. ABI > 1.3 (a high ABI) was also considered abnormal, as an indirect index of artery calcification and stiffness. Results: a total of 5 101 patients were evaluated: 1 212 patients (23.8 %) had ABI = 0.9, and 431 (8.4 %) > 1.3 (including 1 % with incompressible vessels). ABI = 0.9 was associated with age, arterial hypertension, diabetes, current smoking, dyslipidemia and previous vascular events. On the other hand, ABI > 1.3 was associated with male gender, diabetes, previous smoking habit and history of vascular events. A high proportion of patients (62.5 %) with established PAD, identified by a low ABI (= 0.9) were asymptomatic or with minimum symptoms at the time of their assessment. Conclusion: a significant prevalence of abnormal ABI was identified. ABI measurement by Doppler can help to identify patients who need intense secondary prevention and more aggressive treatment of vascular risk factors. [ABSTRACT FROM AUTHOR]

Objectives: to determine the prevalence of peripheral arterial disease (PAD) in type 2 diabetes patients and to measure the strength of the association of selected risk factors. Methodology: a cross-sectional study including two hundred and fifty-two type 2 diabetes patients older than 40 years was conducted in three family medicine clinics, one clinic located within the city and two clinics in the suburb. PAD was diagnosed by Doppler pulsed in the patients with an ankle/arm index < 0.9. Clinical variables: serum cholesterol and triglycerides levels, body mass index (BMI), waist-hip index (WHI), blood pressure (BP) and fasting blood glucose average of the last six months. To ascertain the differences in the prevalence of PAD, χ² test was used; t test was used for quantitative variables; and to estimate the risks the odds ratios were calculated. Results: among urban population the prevalence of PAD was of 25.6 % while for those living in the suburb was 9.8 % (p = 0.002). Serum levels of blood glucose and cholesterol were lower in the latter (p = 0.01 and p = 0.001 respectively). PAD was associated with serum blood glucose levels higher than 140 mg/dL (OR = 3.1; 95 % CI: 1-9.7); total cholesterol higher than 200 mg/dL (OR = 2.8; 95 % CI: 1.1-7.4); proteinuria (OR = 4.9; 95 % CI: 1.7-30.6) and blood pressure higher than 140/90 mm Hg (OR = 2.11; 95 % CI: 1.08-4.14) Conclusions: prevalence of PAD was higher in type 2 diabetes patients receiving care in urban clinics when compared to those cared for at suburban family medicine clinics and its corresponding risk factors showed significant values. [ABSTRACT FROM AUTHOR]