Journal de médecine vasculaire et de chirurgie

Abstrait

Detection of Asymptomatic Peripheral Vascular Disease in Healthy Male Smokers between 21 to 60 years Attending Tertiary Care Hospital using Ankle Brachial Pressure Index in Urban Chennai: An Observational Study

Jayakanthan Saravanan*

Background: PAD affects 10%-15% of the population and about 20% of people aged over 60 years. Worldwide, the incidence of PAD has increased from 164 million in 2000 to 202 million in 2010. 50% of population who have PVD are asymptomatic and therefore do not seek medical assistance, or are not screened by clinicians in the absence of symptoms. Therefore it becomes necessary to screen the individuals who have asymptomatic PVD at early stage as they have the equal risk of morbidity and mortality like those who have obvious symptoms.

In the 1950's, Winsor described the Ankle Brachial Index (ABI), a good and simple non-invasive method for assessing arterial perfusion. It remains a primary clinical diagnostic test for detection of asymptomatic PAD. The lower the ABPI (Ankle–Brachial Pressure Index) value, the higher the risk of all-cause and cardiac mortality in patients with peripheral vascular disease. The predictive value of ABPI in cardiovascular morbidity and mortality is similar to that of traditional Framingham risk factors. McKenna and colleagues evaluated a low ABPI as an independent risk factor for mortality.

Objective:

• Detect the presence of PVD in 300 healthy smokers using the ABPI index

• To find out the association between the No. of pack years of smoking and the severity of PVD

Methods: In our tertiary institute we conducted a study from April 2021 to June 2021 in which we recorded the ABPI index of healthy male smokers between 20 to 60 years and statistical analysis was done to see if there is a positive correlation between the number of pack years of smoking and the duration of smoking with the occurrence of peripheral vascular disease.

Results: Healthy smokers mean age is 49.61 years and standard deviation is 7.49 years. There is a significant, negative, moderate correlation between healthy smokers Age and ABPI index. It means as age increases their ABPI index score decreases moderately. The relationship between the number of pack years and the severity of PVD showed that as the number of pack years and duration of smoking increased, the severity of PVD also increased.

Conclusion: Asymptomatic smokers also have significant peripheral vascular disease and it is positively correlated to the duration, age and the number of pack years of smoking. So it is very essential to screen the smokers though asymptomatic for the peripheral vascular diseases. This can be done by a very effective non-invasive cost effective Ankle brachial pressure index.