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Most patients with peripheral arterial disease (PAD) are asymptomatic and have similar vascular morbidity and mortality with patients with symptomatic PAD. Despite being a very highly prevalent disease, physicians underdiagnose and undertreat PAD. A total of 100 participants with aortic valve sclerosis (AVS) and 100 participants without AVS and age-, gender-, and cardiovascular risk factor–matched participants were enrolled. Ankle–brachial index (ABI) and AVS were evaluated by handheld Doppler device and echocardiography, respectively. There was significantly lower ABI in participants with AVS compared with those without AVS (1.04 ± 0.14 v 1.11 ± 0.07, P = .001). There was a negative correlation between ABI and AVS (r = −.29, P < .001). Linear regression analysis demonstrated an independent association between ABI and AVS (95% confidence interval [CI]: −0.91 to −0.27, P < .001) and β-blocker use (95% CI: −0.96 to −0.02, P: .04). Our findings confirm an association between AVS and PAD that may be attributed to shared vascular risk factors. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to the article "Is aortic valve sclerosis always a surrogate marker for atherosclerosis?" by Olgun HK and colleagues in the 2013 issue.