Metabolic syndrome and asymptomatic peripheral artery disease in subjects over 60 years of age.

The ankle-brachial index (ABI) is a noninvasive, low-cost, and useful test for detecting asymptomatic peripheral artery disease (PAD). An ABI 0.9 has a sensitivity of 95% and a specificity of 99% in identifying PAD when compared with arteriography (1). A low ABI predicts risk of cardiovascular death, myocardial infarction, PAD events, and stroke (2,3). Although an elevated prevalence of a low ABI has been described in subjects with metabolic syndrome and a history of cardiovascular disease (4), there is no information of its possible association in subjects in primary prevention. The objective of the present study was to investigate the association between metabolic syndrome and the presence of asymptomatic PAD, defined by the presence of a low ABI, in subjects 60 years of age without a history of cardiovascular disease or diabetes. Also, we assessed whether the association persisted after adjustment for classical risk factors.