| The Ankle-Brachial Index Test
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The Ankle-Brachial Index Test

The Ankle-Brachial Index Test

The ankle-brachial index test is a quick way for a podiatrist to check for peripheral artery disease (PAD). PAD is a painful condition that develops due to a narrowing of your arteries. This is quite common for people over 55 years of age, occurring in 10 percent of the older cohort.

The Test

The test is relatively simple. It is done by comparing blood pressure readings in your arm and at your ankle.

Just about everyone who has been to a doctor’s office has had their blood pressure measured by the nurse or the doctor. This involves inflating a cuff around your arm, so it squeezes your arm pretty tightly. The inflation is then released, and blood pressure measurements are taken with each heartbeat, allowing doctors to measure your systolic and diastolic blood pressure.


The systolic measurement is your blood pressure when your heat makes a beat, while the diastolic measure is your blood pressure with your heart at rest, in between beats.

If your blood pressure is 120 over 80, that refers to systolic blood pressure over diastolic. By comparing the different readings in your arm and your ankle at the same time, the podiatrist can calculate your Ankle Brachial Index.

Here are basic conclusions that a podiatrist will make when looking at your Ankle Brachial Index.


A score of 1.0 to 1.4

This is the higher range of scores in the index and it indicates no artery blockage in your ankles. It is not conclusive that you don’t have PAD, but it’s a good indicator that you don’t.

A score of  0.91 to 0.99

Scores in this range indicate that you have borderline PAD. Your doctor might order more tests if you have a score in this range.

A score of 0.9 or lower

This is a strong indication that the arteries in your legs or ankle are blocked to some extent. Additional testing might be ordered. The next step, typically, is an ultrasound imaging test or angiography.

PAD can be very painful, enough to limit walking and/or exercise.

Risk factors for PAD include:

  • Diabetes
  • History of smoking
  • High blood pressure
  • High cholesterol
  • Atherosclerosis
  • Advancing years (over 60)

Prevalence And Treatment

According to the U.S. Center for Disease Control and Prevention, 12 percent to 20 percent of U.S. adults have some degree of PAD. However, in 40 percent of the cases, there is no pain involved.

Still, PAD should be taken seriously as it is considered an indicator of higher risks for heart attack and stroke.

Treatment options include:

  • Quitting smoking
  • Changes in diet to reduce cholesterol
  • Medication to reduce cholesterol
  • Anti-platelet medication, such as low-dose aspirin
  • Surgery to correct blockage in arteries
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