Ankle Brachial Index

The ankle-brachial index test is a quick, noninvasive way to check for peripheral artery disease (PAD). The disease occurs when narrowed arteries reduce the blood flow to your limbs. PAD can cause leg pain when walking and increases the risk of heart attack and stroke.

The ankle-brachial index test compares the blood pressure measured at your ankle with the blood pressure measured at your arm. A low ankle-brachial index number can indicate narrowing or blockage of the arteries in your legs.

You may have ankle-brachial index testing before and immediately after walking on a treadmill. An exercise ankle-brachial index test can assess the severity of the narrowed arteries during walking.

Frequently Asked Questions

The ankle-brachial index test is done to check for PAD — narrowed arteries that reduce blood flow, usually in your legs. Research indicates that PAD affects about 10 percent of people over age 55.

Your doctor might recommend an ankle-brachial index test if you have leg pain while walking or risk factors for PAD, such as:

  • History of tobacco use
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Restricted blood flow (atherosclerosis) in other parts of your body

You may feel some discomfort when the blood pressure cuffs inflate on your arm and ankle. But this discomfort is temporary and should stop when the air is released from the cuff.

If you have severe leg pain, your doctor may recommend a different imaging test of the arteries in your legs.

No special preparations are needed for an ankle-brachial index test. The test is painless and similar to getting your blood pressure taken in a routine visit to your doctor. You might want to wear loose, comfortable clothing that allows the technician performing your ankle-brachial index test to easily place a blood pressure cuff on your ankle and upper arm.

During the procedure

  • You likely will be asked to rest for 5 to 30 minutes before the test.
  • Typically, you lie on a table on your back, and a technician measures your blood pressure in both arms and both ankles, using an inflatable cuff and a hand-held ultrasound device that’s pressed on your skin. The device uses sound waves to produce images and allows your pulse to be heard in your ankle arteries after the cuff is deflated.

After the procedure

  • The ankle-brachial index test should take only a few minutes. You don’t need to follow any special precautions afterward. Your doctor will discuss your test result with you.