[Underdiagnosis of peripheral arterial disease in the Spanish population. ARTPER study]

Although peripheral arterial disease (PA) is an important clinical marker of cardiovascular morbimortality, the rate of under-diagnosis is unknown. Our aimed to know the proportion of patients underdiagnosed of PA and the associated factors.

3786 patients >49 years old, randomly selected, were studied. PA was diagnosed by means of the ankle-brachial index (ABI<0, 9). Underdiagnosed was considered when ABI<0, 9 and when they were not diagnosed of PA in the clinical record. We also determined the presence of intermittent claudication (IC) defined by Edinburgh's questionnaire.

7,6% had an ABI <0, 9 (IC95% 6.7-8.4). Of these patients 80.7%, were underdiagnosed, although the 29.3% had IC. PA underdiagnosis was low in current smokers or former smokers (OR 0.20; IC95% 0.07-0.59), if IC (OR 0.40; IC95% 0.18-0.89), if ABI between <0.7 and 0.5 (OR 0.36; IC95% 0.16-0.81) or <0,5 (OR 0.04; IC95 % 0.01-0.20), being higher in >70 years (OR 3.12; IC95% 1.12-8.67).

PA underdiagnosis is high, especially in old patients. It is necessary to reach consensus criteria for the practice of the ABI in the general population.