How 15 Minutes Can Save Your Life

The ankle-brachial index (ABI) test is a simple, non-invasive test that serves to assist healthcare providers in determining whether or not a patient has developed peripheral vascular disease (PVD). In its simplest form, this test allows physicians to assess just how well a patient’s blood is flowing. “No special preparations are needed for an ankle-brachial index test. The test is painless and similar to getting [one’s] blood pressure taken in a routine visit to [a] doctor.” Quick and easy, this 15-minute test can save a patient’s life, helping them to avoid blood clots, heart attack, and stroke — all of which can result from PVD.

An ABI test can help doctors to diagnose PVD, preventing the disease’s progression, as well as any associated complications. Furthermore, ABI tests are an effective method of identifying individuals who may be high-risk for coronary artery disease.

What is Peripheral Vascular Disease (PVD)?

In patients with PVD, a significant amount of plaque builds up in the arteries. A blood circulation disorder, PVD causes the blood vessels, particularly those located outside of the brain and heart, to spasm, narrow, or even block. Most commonly affecting the blood vessels that bring blood to the body’s lower limbs, PVD can significantly limit blood flow. As a result, the limbs may not receive all of the oxygen that they require. This disease can result in severe leg pain and fatigue when walking, climbing stairs, or exercising, as well as numbness. PVD can also elevate a patient’s risk of heart attack and stroke. Unfortunately, PVD is a quite prevalent disease — affecting around 10% of individuals over the age of 55. And not all PAD patients show exhibit symptoms, making the ABI test even more crucial.

However, there are several lifestyle choices, behaviors, medical characteristics, etc. that can increase a patient’s risk of PVD — including, but not limited to:

  • Diabetes
  • Smoking
  • Hypertension, or high blood pressure
  • High cholesterol
  • Being over 70 years of age
  • Atherosclerosis, or restricted blood flow in other areas of the body
  • Abnormal pulses in the lower limbs

What Occurs Before and During the ABI Test?

Before an ABI test, it is standard procedure for patients to rest for a period of between 15 and 30 minutes. Nevertheless, some individuals might be required to walk on a treadmill immediately before and after an ABI test. Exercise ABI tests allow physicians to better assess the severity of narrowed arteries during physical activity, like walking. It is important to note that the range of results of an exercise ABI test may differ from the standard ABI test.

During an ABI test, a patient lies down on their back. Then, “a technician takes [their] blood pressure in both… arms using an inflatable cuff, similar to the one used in the doctor’s office,” and a handheld ultrasound device. By utilizing sound waves to generate images, this ultrasound device enables the technician to listen to the blood flow through the vessel following the deflation of the cuff. Next, the technician measures the blood pressure in the patient’s ankles. Using these blood pressure values, the technician can calculate the patient’s ABI.

To calculate ABI, a health care provider divides the blood pressure value in an artery of the ankle by the blood pressure value of an artery in the arm. If the resulting ratio equals less than 0.9, the patient may have developed PVD.

What Occurs Following the ABI Test?

Following an ABI test, individuals should be able to return to normal activities. However, an individual must follow up with their doctor regarding the results of this test. Follow-up testing, like an MRI or an arteriogram, may be required in some cases so that physicians may gather more information regarding a blocked vessel.

If an ABI test determines that an individual does have PVD, treatment may be required. Treatment options for PVD might include:

  • Addressing diabetes, hypertension, or high cholesterol
  • Quitting smoking
  • Maintaining a physically active lifestyle
  • Sticking to a healthy diet
  • Undergoing procedures, like angioplasty, to restore blood flow
  • Taking a prescription which aims to boost blood flow to the legs or helps to avert blood clots


Although some may feel some temporary discomfort as a result of the blood pressure cuff inflating on their arm or ankle, this test should not present any risks for most individuals. However, patients that have a blood clot one of their legs are not advised to undergo an ABI test. And for individuals experiencing dramatic leg pain, healthcare providers may suggest an alternative imaging test of the legs’ arteries.

Results and Next Steps

According to the ABI calculated, doctors are better equipped to treat their patients and can determine if further testing is required. For example, an ABI ranging from 1.0 to 1.4 indicates that a patient most likely does not have PVD. However, if a patient does exhibit symptoms consistent with PVD, it may be necessary to perform an exercise ABI test. Moreover, an ABI ranging from 0.91 to 0.99 can indicate borderline PVD. In this instance, a physician may also require an exercise ABI test. And an ABI of under 0.90 is considered abnormal and signifies a high likelihood of PVD. Additional testing, like an angiogram or ultrasound, may be requested by a healthcare provider, allowing them to better view the arteries in their patient’s lower limbs.

In patients with diabetes or significant blockages, technicians might need to perform a toe-brachial index test instead of an ABI test to get the most accurate reading. In such cases, patients may need to make lifestyle changes, take certain medications, or undergo surgery.

Visit Dr. Beheshtian for an ABI Test

With the help of a skilled and experienced medical professional, individuals can proactively address their cardiovascular health and prevent hardening of the arteries, blood clots, heart attack, stroke, etc. Dr. Beheshtian is an interventional cardiologist who has treated over 1000 patients in New York and elsewhere. She is extremely knowledgeable about treatment paths for various types of cases, mild or complex.

Please feel free to contact Avicenna Cardiology’s office with any questions or to schedule your ABI test. Dr. Beheshtian will work with you to create a care plan, address lifestyle changes, and help you to monitor your overall heart health!

About the Author

Azadeh Beheshtian

Azadeh Beheshtian is board certified in cardiovascular disease and internal medicine by the American Board of Internal Medicine. She specializes in interventional cardiology and peripheral artery disease, with a focus on women’s heart health.