Association between intermittent claudication and peripheral arterial disease in essential hypertensive patients.

Authors

Keywords:

peripheral arterial disease, hypertension, intermittent claudication.

Abstract

Introduction: Peripheral arterial disease is related, per se, with atherosclerosis. Its early diagnosis allows taking measures aimed at slowing its progression.

Objective: To assess whether presenting intermittent claudication is associated with peripheral arterial disease in essential hypertensive patients, additionally it was evaluated if the years of evolution of the disease and the hypertensive stage were effect modifiers of the association of interest.

Methods: Prospective cohort study, with cross-sectional, two-stage analysis, carried out in an Internal Medicine Clinic, in the city of Pucallpa (Ucayali-Peru). The Edinburgh intermittent claudication questionnaire was applied to each patient and the ankle-brachial index was subsequently calculated.

Results: Among the 194 hypertensive patients included, the mean age was 59.5 years, 59.8% were men, and 90% had some comorbidity. Intermittent claudication occurred in 51.0%. The systolic blood pressure had a mean 141 mmHg and the diastolic of 80 mmHg, 57.2% had an evolution of the disease greater than 10 years and 53.1% belonged to hypertensive stage I. Suffering from peripheral arterial disease was greater in the group with intermittent claudication (adjusted OR: 3.66, 95% CI: 1.97 to 7.20), in hypertensive patients with stage II (adjusted OR: 1.46, 95% CI: 1.21 to 1.75), without differences in relation to the evolution of arterial hypertension. Conclusions: In hypertensive patients essentially presenting intermittent claudication is associated with peripheral arterial disease, mainly in patients with stage II.

Downloads

Download data is not yet available.

References

Casey S, Lanting S, Oldmeadow C, Chuter V. The reliability of the ankle brachial index: a systematic review. J Foot Ankle Res. 2019;12:39. DOI: https://doi.org/10.1186/s13047-019-0350-1

Moussa Pacha H, Mallipeddi VP, Afzal N, Moon S, Kaggal VC, Kalra M, et al. Association of ankle-brachial indices with limb revascularization or amputation in patients with peripheral artery disease. JAMA Netw Open. 2018 [acceso 08/10/2022];1(8):e185547. Disponible en: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2717558

Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: Executive summary: A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation. 2017 [acceso 08/10/2022];135(12):e686-725. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479414/

Herráiz-Adillo Á, Soriano-Cano A, Martínez-Hortelano JA, Garrido-Miguel M, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, et al. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study. Blood Press. 2018 [acceso 08/10/2022];27(2):112-9. Disponible en: https://www.tandfonline.com/doi/full/10.1080/08037051.2017.1400903

Ichihashi S, Desormais I, Hashimoto T, Magne J, Kichikawa K, Aboyans V. Accuracy and reliability of the ankle brachial index measurement using a multicuff oscillometric device versus the Doppler method. Eur J Vasc Endovasc Surg. 2020 [acceso 08/10/2022];60(3):462-8. Disponible en: https://www.ejves.com/article/S1078-5884(20)30531-1/fulltext

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Hypertension. 2018 [acceso08/10/2022];71(6):e13-115. Disponible en: https://www.ahajournals.org/doi/full/10.1161/HYP.0000000000000066

Leng GC, Fowkes FG. The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys. J Clin Epidemiol. 1992;45(10):1101-9. Disponible en: https://doi.org/10.1016/0895-4356(92)90150-L

Tackling G, Borhade MB. Hypertensive heart disease. En: StatPearls. StatPearls Publishing; 2021. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK539800/

García Herrera AL, Jiménez Abreu I de la C, Moliner Cartaya M. Cuestionario de Edimburgo modificado para diagnosticar la claudicación arterial en atención primaria de salud. Rev cuba angiol cir vasc. 2019 [citado 08/10/2022];20(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1682-00372019000200005

Aguilera Lagos R, Díaz López EJ, Colman Juárez BL, Carranza Pagoada RE, Padilla Meza JC, Cáceres Munguía GI. Enfermedad arterial periférica y diabetes mellitus de tipo 2 en atención primaria. Rev cuba angiol cir vasc. 2020 [citado 08/10/2022];21(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1682-00372020000200003

Zemaitis MR, Boll JM, Dreyer MA. Peripheral Arterial Disease. En: StatPearls. StatPearls Publishing; 2021. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK430745/

Negrín Valdés T, Rodríguez Jiménez AE, Fardales Rodríguez R, Castellanos Gallo LA, Meneses Jiménez JC, López Callejas MA. El índice tobillo-brazo como predictor de enfermedad coronaria multivaso en pacientes con síndrome coronario agudo y enfermedad arterial periférica. Finlay. 2020 [acceso 08/10/2022];10(3):209-21. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2221-24342020000300209

Félix-Redondo FJ, Subirana I, Baena-Diez JM, Ramos R, Cancho B, Fernández-Bergés D, et al. Importancia pronóstica de la enfermedad arterial periférica diagnosticada mediante el índice tobillo-brazo en la población general española. Aten Primaria. 2020 [acceso 08/10/2022];52(9):627-36. Disponible en: https://www.sciencedirect.com/science/article/pii/S0212656720301062

Antezana Llaveta G. Índice tobillo-brazo como determinante de enfermedad arterial obstructiva periférica en adultos mayores. Gac médica bolív. 2021 [acceso 08/10/2022];44(2):162-6. Disponible en: http://www.scielo.org.bo/scielo.php?pid=S1012-29662021000200162&script=sci_arttext

Velescu A, Clara A, Martí R, Ramos R, Pérez-Fernández S, Marcos L, et al. El índice tobillo-brazo anormalmente alto se asocia con todas las causas y mortalidad cardiovascular: el estudio REGICOR. Eur J Vasc Endovasc Surg. 2017 [acceso 07/09/2022];54(3):370-7. Disponible en: https://www.ejves.com/article/S1078-5884(17)30372-6/fulltext

León-Rey CC, Lecuona-Huet NE, Fabián-Mijangos W, Betanco-Peña AX, Casares-Bran TM, Rodríguez-López JE. Propuesta de algoritmo diagnóstico en enfermedad arterial periférica con laboratorio vascular no invasivo en el Hospital General de México. Rev Mex Angiol. 2017 [acceso 08/10/2022];45(4):170-92. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=77886 .

Myslinski W, Stanek A, Feldo M, Mosiewicz J. Ankle-Brachial Index as the Best Predictor of First Acute Coronary Syndrome in Patients with Treated Systemic Hypertension. Biomed Res Int. 2020 [acceso 08/10/2022];17:6471098. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382730/

Cáceres-Farfán L, Moreno-Loaiza M, Cubas WS. Ankle-brachial index: more than a diagnostic test? Arch Perú Cardiol Cir Cardiovasc. 2021 [acceso 08/10/2022];2(4):254-62. Disponible en: https://apcyccv.org.pe/index.php/apccc/article/view/168

Ena J, Pérez-Martín S, Argente CR, Lozano T. Association between an elevated inter-arm systolic blood pressure difference, the ankle-brachial index, and mortality in patients with diabetes mellitus. Clin Investig Arterioscler. 2020 [acceso 08/10/2022];32(3):94-100. Disponible en: https://www.sciencedirect.com/science/article/pii/S0214916819301469

Sasaki M, Mitsutake Y, Ueno T, Fukami A, Sasaki KI, Yokoyama S, et al. Low ankle brachial index predicts poor outcomes including target lesion revascularization during the long-term follow up after drug-eluting stent implantation for coronary artery disease. J Cardiol. 2020 [acceso 08/10/2022];75(3):250-4. Disponible en:

https://www.sciencedirect.com/science/article/pii/S0914508719302412

Nakahashi T, Tada H, Sakata K, Yakuta Y, Tanaka Y, Gamou T, et al. Impact of decreased ankle-brachial index on 30-day bleeding complications and long-term mortality in patients with acute coronary syndrome after percutaneous coronary intervention. J Cardiol. 2019 [acceso 13/10/2022];74(2):116-22. Disponible en: https://www.journal-of-cardiology.com/article/S0914-5087(19)30014-0/fulltext

Published

2022-12-22

How to Cite

1.
Santana Téllez TN, Del Águila Grandez AY. Association between intermittent claudication and peripheral arterial disease in essential hypertensive patients. Rev. cuba. cardiol. cir. cardiovasc. [Internet]. 2022 Dec. 22 [cited 2025 Mar. 10];28(4):e1394. Available from: https://revcardiologia.sld.cu/index.php/revcardiologia/article/view/1394

Issue

Section

Original Articles