Ask ADC: Ankle-Brachial Index Test

A nurse holds a small probue to a foot

An ADC nurse performs an ankle-brachial index test.

Peripheral artery disease (PAD) is a common but undiagnosed condition. Ten million Americans are affected by this condition, which is caused by narrow or blocked arteries in the body, particularly the legs.

Often the symptoms of PAD, which include cramping, pain or tiredness in the legs and hips while walking, are mistaken for something else. However, PAD can lead to more serious conditions, and people with PAD have a higher risk for heart attack or stroke. It can also lead to gangrene and amputation.

Risks for peripheral artery disease

Some of the risks for peripheral artery disease can’t be controlled, like your age, or family history. But some risk factors can be controlled.

  • Smoking is one of the top risk factors for PAD, because it can increase your risk by 4 times. Quitting is the best way to cut your risk.
  • Diabetes increases your risk, but managing your condition and blood sugar levels can help.
  • Obesity – If you are overweight or obese, you should lose and maintain a normal body weight. Being physically active and eating a healthy diet can help your lose weight and decrease your risk.
  • High blood pressure can weaken your arteries, but it often has no symptoms. Talk with your doctor about how to lower your blood pressure.
  • High cholesterol can contribute to plaque build-up which can lead to narrowed or blocked arteries, so managing your cholesterol is important to reduce your risk.

Symptoms for peripheral artery disease

Most patients with PAD have no symptoms until the disease is advanced.

The most common symptom of PAD is muscle cramping in your leg of hip muscles while walking, climbing stairs or exercising. The pain is your body’s warning that working muscles, which need more blood flow, aren’t getting what they need. The pain may go away once you stop moving, but it could take a few minutes.

Other symptoms include:

  • Leg pain that doesn’t go away after exercise
  • Foot wounds that heal slowly or not at all
  • Cold or numb feet
  • Decreased leg strength and poor balance while standing

What is an Ankle-brachial index test?

The ankle-brachial index test is one of the screening tools your doctor can use to detect peripheral artery disease. It is a quick, non-invasive test that compares the blood pressure measured at your ankle with your blood pressure measured at your arm. An abnormal reading could mean there is a narrow or blocked artery.

How does it work?

During an ankle-brachial index test (ABI), you lie on your back while a technician measures the blood pressure in both your arms. Then they will measure the blood pressure in two arteries in your ankle using both an inflatable cuff and a hand-held doppler ultrasound probe. The probe is placed lightly against your skin and uses sound waves to create images of the insides of your arteries.

The test takes approximately 15 minutes.

Who should be tested?

Your doctor may recommend this test is you are over the age of 50 and have any of the risk factors for peripheral artery disease.

What happens next?

If the ankle-brachial reading is abnormal, your doctor may initially recommend aggressive lifestyle changes. But he or she may also order additional imaging tests, medications, or certain procedures to treat the condition.

Talk to your doctor about which treatment is best for you.

Additional Resources

Peripheral artery disease