An ankle brachial index is an important test your doctor may want you to do if you have some other risk factors.  An ankle brachial index test is done to check for Peripheral Artery Disease, or PAD.  Peripheral Artery Disease is plaque buildup in arteries of the arms or legs.  Ten percent of people over the age of 55 have Peripheral Artery Disease. 

An ankle brachial index test compares the blood flow of the upper and lower limbs.  This test can diagnose PAD as well as prevent progression and complications.  It can also help identify people at higher risk for coronary artery disease.  


Why do I need an ankle brachial index test?

An ankle brachial index test may need to be done on people who have a history of tobacco use, diabetes, high blood pressure, high cholesterol, restricted blood flow, are older than 70, or abnormal pulses in lower legs. 

If you have symptoms of Peripheral Artery Disease your doctor may want to do an ankle brachial index test to diagnose.  Symptoms of PAD such as pain when you climb stairs, heavy, numb, weak legs, less hair on your legs than normal, one leg feels colder, skin looks pale or blue, sores on toes or feet, or toenails grow more slowly than normal can also warrant an ankle brachial index test.  


What to expect when you take an ankle brachial index test.

There are two different types of ankle brachial index tests you can have done. One is an exercise ankle brachial index, or one that does not include exercise.

The exercise ankle brachial index test will be done while walking on a treadmill.  You will walk at 3km/hr at an incline of 5 degrees.  The test will last five minutes.  The test can be shorter if there are difficulties while the test is being done.

The ankle brachial index test that doesn’t require exercise will take about 10-15 minutes.  You will lie down on the table.  Blood pressure of one arm will be done with a doppler to hear the blood flow.  After that is achieved then both ankle blood pressures will be done.

An exercise ankle brachial index test would be recommended if there are signs of poor circulation such as claudication.


Understanding Ankle Brachial Index Test Numbers

After the tests are completed the numbers will be used to calculate the ankle brachial index of each leg. 

If your numbers are .9 or less you will be diagnosed with Peripheral Artery Disease.  The lower the number the more blockage you have. 

If your numbers are .91-.99 then you are borderline Peripheral Artery Disease. 

Numbers ranging 1-1.4 no Peripheral Artery Disease is present. 

Over 1.4 and your arteries are too stiff.  This causes the test to be inconclusive and not helpful because your blood pressure cannot be taken with normal blood pressure cuffs.  


Treatment Options

Your doctor will have a treatment plan for you once your ankle brachial index has been found.  It may just be that you will need to retest in the future.  Other things that your doctor may want you to do are lifestyle changes, medications, or surgery if severe.  Some lifestyle changes that you may need to change are to stop smoking, eat healthy, and exercise regularly.  You may need to treat high blood pressure, high cholesterol, and diabetes if they are an issue.  Medications can be taken to increase blood flow or to prevent blood clots.  An angioplasty can be done to help restore blood flow in a leg if necessary.  Surgery can be done on your legs if the blockage is severe.  



There are lots of different risk factors that could alert your doctor in wanting to find your ankle brachial index test.  The test can help your doctor identify if you are having pain in numbness in your legs.  Peripheral Artery Disease can be treated when diagnosed.  About 10 percent of people over 55 have Peripheral Artery Disease, so it is not unlikely for your doctor to want to test you if he suspects there to be any trouble. 


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