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The United States Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against using the ankle-brachial index (ABI) as a screening test for peripheral artery disease (PAD) in asymptomatic adults.
PAD is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. In addition to morbidity directly caused by PAD, patients have an increased risk for cardiovascular disease (CVD) events.
Screening asymptomatic patients could reduce patient morbidity and mortality by identifying patients who are at hidden risk for CVD. The ABI is the ratio of the ankle and brachial systolic blood pressure that has been used as a marker for PAD.
In 2005, the Task Force recommended against using ABI as a screening test for PAD because there was little evidence that screening would improve outcomes any more than treatment based on standard CVD risk assessment. To inform the update, researchers assessed new evidence on the ability of the ABI to predict cardiovascular disease morbidity and mortality independent of the Framingham Risk Score (FRS) in asymptomatic adults. They also assessed the benefits and harms of treating adults found to have PAD through screening.
The researchers found insufficient evidence to assess the balance of benefits and harms of screening for PAD and CVD risk assessment with ABI. They also found insufficient evidence to establish the benefits of treating screening-detected PAD in asymptomatic individuals.
"The Ankle - Brachial Index for Peripheral Artery Disease Screening and Cardiovascular Disease Prediction Among Asymptomatic Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force" Jennifer S. Lin, MD, MCR; Carin M. Olson, MD, MS; Eric S. Johnson, PhD; and Evelyn P. Whitlock, MD, MPH, Ann Intern Med. 2013;159(5):333-341. doi:10.7326/0003-4819-159-5-201309030-00007
Annals of Internal Medicine Sept. 3 2013
Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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American College of Physicians. "Task Force: Not enough evidence to recommend for or against screening for peripheral artery disease in asymptomatic adults." Medical News Today. MediLexicon, Intl., 5 Sep. 2013. Web.
6 Dec. 2013. <http://www.medicalnewstoday.com/releases/265607>
American College of Physicians. (2013, September 5). "Task Force: Not enough evidence to recommend for or against screening for peripheral artery disease in asymptomatic adults." Medical News Today. Retrieved from
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