The measurement of atherosclerotic peripheral arterial disease in epidemiological surveys.

In cardiovascular surveys, the WHO questionnaire on intermittent claudication has traditionally been used as a measure of atherosclerotic peripheral arterial disease of the lower limbs. But the questionnaire is of limited value because atherosclerotic disease is frequently asymptomatic. Research on the validity and reliability of the questionnaire and the simpler non-invasive tests of peripheral arterial disease are reviewed. These tests include measurement of the ankle-brachial systolic pressure ratio, a treadmill exercise test, a reactive hyperaemia test, and assessment of toe-pulse reappearance time. The performance of these non-invasive tests is such that they should be used, in conjunction with the intermittent claudication questionnaire, in epidemiological studies of atherosclerotic peripheral arterial disease of the lower limbs.