The ankle–brachial index (ABI), a simple, non–invasive 10–minute test should be incorporated into a routine physical exam for diagnosing peripheral arterial disease in the middle aged and the elderly, especially those with heart attack risk factors like smokers, diabetics and the ones with high BP or cholesterol levels.

With the patient in a supine position, the doctor takes blood pressure readings from both arms; he then takes blood pressure readings from both ankles with a sphygmomanometer and Doppler device. ABI value is calculated by dividing the higher systolic pressure in each leg by the higher systolic brachial pressure.

ABI scores should be interpreted as follows:

• Greater than 0.90: Normal
• 0.71 – 0.90: Mild obstruction
• 0.41 – 0.70: Moderate obstruction
• Less than 0.40: Severe obstruction
• More than 1.30: Calcification of the vessels

Presence of peripheral arterial disease may indicate associated blockages in the heart and proneness to heart attack or paralysis.