The ankle–brachial index (ABI), a simple, non–invasive 10–minute test should be incorporated into a routine physical exam to diagnose 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
• 71 – 0.90: Mild obstruction
• 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.