Ankle-brachial indices determined from the ratio of pressure in the sural arteries of the lower extremities and the brachial artery with the Dopplex apparatus, are applied foremost in diabetics for the demonstration of ischemia in the lower extremities. A decrease in the indexes (<0.9) is not only a sign of ischemic disease in the lower extremities but namely an important prognostic indicator of the risk of atherosclerosis, i.e. myocardial infarction and cerebrovascular events in the next 5-7 years. In order to reveal the prevalence of decreased ankle-brachial indices, in 2003 at the offices of 14 general practitioners there has been carried out an investigation in 333 males of middle age, among whom there were 54 (16%) subjects suffering from diabetes mellitus. Decreased ankle indexes have been demonstrated in 51 (15%) males upon examination of the crural arteries of the lower extremities with a Mini-Dopplex II apparatus. They were significantly more frequently associated with diabetes and hypertension, as well as increased glycemia and/or triglycerides. This association with indicators of insulin resistance is in agreement with the experience that the risk of atherosclerosis complications, i.e. myocardial infarction or cerebrovascular events can be increased even before manifest diabetes mellitus. The availability of manually controlled Dopplex apparatuses could so contribute to improved detection of persons in risk in primary care even before the manifestation of clinical complications.

        Key words: primary care - atherosclerosis - ischemic disease - lower extremities - ankle-brachial indices - insulin resistance - diabetes mellitus.