The crucial blood pressure ratio your doctor probably isn’t checking

The crucial blood pressure ratio your doctor probably isn’t checking

In July, the media was all hot and bothered about a “new” test that can help doctors determine whether patients with peripheral artery disease will eventually have problems walking. The news report I read said ” a simple test called the ankle/brachial index (ABI) can help predict future walking problems in patients with peripheral arterial disease, a condition that involves hardening of the blood vessels in the legs and elsewhere, new research shows.”

“New research?” Those “quack” doctors who practice the radical concept of preventive medicine have been using this test for 40 years!

In the 1960s, I tried to tell my colleagues in Sarasota about this method. They weren’t the slightest bit interested. But the ABI can be determined in just a few minutes with standard equipment. All it involves is measuring the blood pressure in the ankle and in the arm and determining the ratio between them by dividing the ankle measurement by the arm measurement. Any value below 1 is considered abnormal and values below 0.25 indicate severe blood flow problems that could result in amputation of the leg if left untreated.

“Our findings,” reported doctors from Northwestern University Medical School, “underscore the importance of using the ABI test to identify persons with peripheral arterial disease, since (it) is frequently undiagnosed or symptomless.”

I’d go even further in “underscoring the importance” of this test: This simple procedure is so crucial that it should be performed on every patient over the age of 60–50 if he is a diabetic.

I wonder how many legs have been lost in Sarasota because of the lack of interest among the doctors I tried to convert? And across the nation? A small mountain of amputated legs, I would think. But don’t let yours wind up at the top of the heap.

Action to take:

Talk to your doctor about having this simple test done, and if your results are abnormal, check out the recommendations for preventing amputation in the Health Note to the right.


“ABI and leg symptoms predict functional decline in peripheral arterial disease,” Reuters Health News, 7/27/04

“Functional decline in peripheral arterial disease: associations with the ankle brachial index and leg symptoms.” JAMA 2004; 292(4): 453-461