Do I need Ankle-Brachial Index(ABI)?

 

Family Healthcare & Cardiac Center

Cardiovascular clinic with trusted cardiologist & vein specialists, offering wide range of vascular tests, imaging & treatments in Bay Ridge, Brooklyn, NY.

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In the world of cardiovascular health, ABI stands for Ankle-Brachial Index. An ABI test is used to assess circulation in the legs and arms. An ABI test can identify circulation problems in the limbs - or Peripheral Artery Disease - before it causes symptoms that can be seen. But is it worthwhile to give every patient an ABI?

The article that brought all of this to our attention came from Newsroom: “Asymptomatic Adults Do Not Need Peripheral Artery Disease Screening, USPSTF Says.” The USPSTF is an independent panel of medical experts who seek to improve preventative care by gauging the effects of standard preventative treatments. When I looked for the original report from the USPSTF, however, I found that their recommendation was worded a little differently. Their conclusion was that “the current evidence is insufficient to assess the balance of benefits and harms of screening … with the ankle-brachial index (ABI) in adults.”

Should you be getting regular ABI tests? Do the benefits outweigh the harm?

First of all, when we talk about the “harm” of an ABI, we’re only talking about the patient’s time and the cost of running the test. There is absolutely no risk to the patient receiving an ABI test. Sensors, not needles, are secured to the foot and hand with clips or velcro. A computer attached to the sensors compares blood pressure in each limb. The test takes only a few minutes and uses no harmful rays or chemicals.

What if an ABI test comes back positive? Half of patients with Peripheral Artery Disease did not know they had it before they were tested; they had not noticed any symptoms. Patients with mild to moderate PAD have the chance to treat their circulation problem with diet and exercise before medication or even surgery becomes necessary. Even if surgery or medication is required, it will be more effective if it’s done earlier rather than later.

Vascular disease can affect different parts of the body. Coronary Artery Disease affects the area around the heart. CAD often causes classic cardiac symptoms like chest pain, arm pain, shortness of breath, and nausea. Meanwhile, if the blockage is in the limb, the patient has Peripheral Artery Disease, which causes symptoms more easily mistaken for “normal old-age,” like slowing leg-hair growth, frequent pins and needles, or an inability to walk short distances.

But, does earlier knowledge result in more health-conscious action from the patient? Now, that’s a question for psychologists. Some would surely heed the wake-up call, but many would simply avoid the doctor. Some studies have even shown that testing negative for a preventable disease can inspire patients to relax their diet and exercise habits.

Whatever the results, an ABI test can’t help you unless you’re willing to make a permanent commitment to healthy choices. But the test will provide your doctor with more information about your cardiovascular health, and that is never a bad thing.

But is it necessary? If an ABI test shows that a patient has mild PAD, the likely suggestion will be improvements to diet and exercise, and you don’t need a test to know how important those are. Anyone can improve their cardiovascular health by eating less salt or doing more yoga; you don’t need to wait for a disease to form.

ABIs can be helpful, but not as helpful as a strong dedication to a healthy lifestyle. If you experience symptoms of PAD, see your doctor for an ABI. If you haven't had any symptoms, it's better for you to focus on keeping yourself active and healthy than to be tested unnecessarily.

 

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