ankle brachial index


Summary: Comparison of the BLOOD PRESSURE between the BRACHIAL ARTERY and the POSTERIOR TIBIAL ARTERY. It is a predictor of PERIPHERAL ARTERIAL DISEASE.

Top Publications

  1. Miguel J, Matos J, Lugon J. Ankle-Brachial Index as a Predictor of Mortality in Hemodialysis: A 5-Year Cohort Study. Arq Bras Cardiol. 2017;108:204-211 pubmed publisher
    ..However, after adjustment for potential confounders, only low ABI persisted as an independent risk factor for all-cause mortality among hemodialysis patients. ..
  2. Potier L, Halbron M, Bouilloud F, Dadon M, Le Doeuff J, Ha Van G, et al. Ankle-to-brachial ratio index underestimates the prevalence of peripheral occlusive disease in diabetic patients at high risk for arterial disease. Diabetes Care. 2009;32:e44 pubmed publisher
  3. Shin D, Lee Y, Oh J, Yoon J, Rhee S, Kim E, et al. Vascular calcification and cardiac function according to residual renal function in patients on hemodialysis with urination. PLoS ONE. 2017;12:e0185296 pubmed publisher
    ..9 ml/min/1.73m2 (P = 0.08). Residual renal function was significantly associated with vascular calcification and left ventricular diastolic dysfunction in patients on hemodialysis. ..
  4. Igari K, Kudo T, Toyofuku T, Inoue Y. Endothelial dysfunction in patients with Buerger disease. Vasc Health Risk Manag. 2017;13:317-323 pubmed publisher
    ..The patients treated with lumbar sympathectomy might be more appropriate to evaluate their endothelial function by a peripheral arterial tonometry test. ..
  5. Hwang D, Lee K, Park M, Choi S, Park J, Cho J, et al. Association between diabetic foot ulcer and diabetic retinopathy. PLoS ONE. 2017;12:e0175270 pubmed publisher
    ..To prevent blindness, patients with DFU, and especially those with high serum creatinine, should undergo retinal examinations for timely PDR diagnosis and management. ..
  6. Moyer V. Screening for peripheral artery disease and cardiovascular disease risk assessment with the ankle-brachial index in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159:342-8 pubmed publisher
    ..The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for PAD and CVD risk assessment with the ABI in adults. (I statement). ..
  7. McDermott M. Sex Differences in the Ankle Brachial Index Measurement and Interpreting Findings of Sex Differences in Peripheral Artery Disease Burden. Circ Cardiovasc Qual Outcomes. 2016;9:S5-7 pubmed publisher
  8. Miura T, Minamisawa M, Ueki Y, Abe N, Nishimura H, Hashizume N, et al. Impressive predictive value of ankle-brachial index for very long-term outcomes in patients with cardiovascular disease: IMPACT-ABI study. PLoS ONE. 2017;12:e0177609 pubmed publisher
    ..This suggests that more attention should be paid to patients with borderline ABIs, especially with regard to cardiovascular death, stroke, and heart failure. ..
  9. Roumia M, Aronow H, Soukas P, Gosch K, Smolderen K, Spertus J, et al. Sex differences in disease-specific health status measures in patients with symptomatic peripheral artery disease: Data from the PORTRAIT study. Vasc Med. 2017;22:103-109 pubmed publisher
    ..20, p=0.904). Despite similar ABIs, women presenting with symptoms of PAD had poorer PAD-specific functioning as compared with men, impacting all major health status domains, independent of socio-economic and clinical characteristics. ..

More Information


  1. Gómez Sánchez L, Garcia Ortiz L, Patino Alonso M, Recio Rodriguez J, Feuerbach N, Marti R, et al. Glycemic markers and relation with arterial stiffness in Caucasian subjects of the MARK study. PLoS ONE. 2017;12:e0175982 pubmed publisher
    ..Clinical Identifier: NCT01428934. Registered 2 September 2011. Retrospectively registered. Last updated September 8, 2016. ..
  2. Patel S, Chakkera H, Wennberg P, Liedl D, Alrabadi F, Cha S, et al. Peripheral arterial disease preoperatively may predict graft failure and mortality in kidney transplant recipients. Vasc Med. 2017;22:225-230 pubmed publisher
    ..Screening for PAD is important in this patient population because of the potential impact on long-term outcomes. ..
  3. Kawai M, Mihara S, Takahagi S, Iwamoto K, Hiragun T, Hide M. Evaluation of skin perfusion pressure to assess refractory foot ulcers. J Wound Care. 2017;26:267-270 pubmed publisher
    ..The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM. ..
  4. McDermott M, Polonsky T, Kibbe M, Tian L, Zhao L, Pearce W, et al. Racial differences in functional decline in peripheral artery disease and associations with socioeconomic status and education. J Vasc Surg. 2017;66:826-834 pubmed publisher
    ..Black PAD patients have higher rates of mobility loss and becoming unable to walk for 6 minutes continuously. These differences appear related to racial differences in socioeconomic status and physical activity. ..
  5. Waliszewski M, Redlich U, Breul V, Tautenhahn J. Surrogate and clinical endpoints for studies in peripheral artery occlusive disease: Are statistics the brakes?. Pol Przegl Chir. 2017;89:39-48 pubmed publisher
    ..As regards the benefit for the patients and for the payers, walking distance and the ankle brachial index (ABI) are the most feasible endpoints in a relatively small study samples given that other non-vascular ..
  6. Kim A, Shevitz A, Morrow K, Kendrick D, Harth K, Baele H, et al. Characterizing tissue perfusion after lower extremity intervention using two-dimensional color-coded digital subtraction angiography. J Vasc Surg. 2017;66:1464-1472 pubmed publisher
    ..The AT may be the most sensitive marker of perfusion change in the lower extremity. Quantitative thresholds based on 2DP hold promise for immediate treatment effectiveness assessment in patients with PAD. ..
  7. Lin J, Olson C, Johnson E, Whitlock E. The ankle-brachial index for peripheral artery disease screening and cardiovascular disease prediction among asymptomatic adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;159:333-41 pubmed publisher
    ..Adding the ABI to the FRS probably has limited value for predicting CAD or CVD. Treatment benefits for asymptomatic individuals with screen-detected PAD are not established. Agency for Healthcare Research and Quality. ..
  8. Johnson S, Figueroa A, Navaei N, Wong A, Kalfon R, Ormsbee L, et al. Daily blueberry consumption improves blood pressure and arterial stiffness in postmenopausal women with pre- and stage 1-hypertension: a randomized, double-blind, placebo-controlled clinical trial. J Acad Nutr Diet. 2015;115:369-77 pubmed publisher
    ..11±7.95 μmol/L), whereas there were no changes in the control group. Daily blueberry consumption may reduce blood pressure and arterial stiffness, which may be due, in part, to increased nitric oxide production. ..
  9. Zheng Y, Liang L, Qin T, Yang G, An S, Wang Y, et al. Cross-section analysis of coal workers' pneumoconiosis and higher brachial-ankle pulse wave velocity within Kailuan study. BMC Public Health. 2017;17:148 pubmed publisher
    ..001). For patients with CWP, increased baPWV was associated with traditional cardiovascular risk factors and long-term silica dust exposure. ..
  10. Hsu B, Lee C, Yang C, Chen Y, Wang J. High serum resistin levels are associated with peripheral artery disease in the hypertensive patients. BMC Cardiovasc Disord. 2017;17:80 pubmed publisher
    ..176; 95% confidence interval [CI], 1.028-1.345; p?=?0.018) was also an independent predictor of PAD in hypertensive patients. A high serum resistin level is an independent predictor of PAD in hypertensive patients. ..
  11. Imamura H, Yamaguchi T, Nagayama D, Saiki A, Shirai K, Tatsuno I. Resveratrol Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Type 2 Diabetes Mellitus. Int Heart J. 2017;58:577-583 pubmed publisher
    ..Resveratrol may be beneficial in preventing the development of atherosclerosis induced by diabetes. However, a large-scale cohort study is required to validate the present findings. ..
  12. Foraster M, Eze I, Schaffner E, Vienneau D, Héritier H, Endes S, et al. Exposure to Road, Railway, and Aircraft Noise and Arterial Stiffness in the SAPALDIA Study: Annual Average Noise Levels and Temporal Noise Characteristics. Environ Health Perspect. 2017;125:097004 pubmed publisher
    ..The impact of different transportation noise sources and noise environments on arterial stiffness remains unknown...
  13. Zahner G, Gruendl M, Spaulding K, Schaller M, Hills N, Gasper W, et al. Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry. J Vasc Surg. 2017;66:1518-1526 pubmed publisher
    ..Further prospective data are needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population. ..
  14. Singh G, Armstrong E, Waldo S, Alvandi B, Brinza E, Hildebrand J, et al. Non-compressible ABIs are associated with an increased risk of major amputation and major adverse cardiovascular events in patients with critical limb ischemia. Vasc Med. 2017;22:210-217 pubmed publisher
    ..35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI. ..
  15. Li Y, Li Q, Liang S, Liang X, Zhou W, He H, et al. A novel use of hill function and utility of 99mTc-MIBI scintigraphy to detect earlier lower extremity microvascular perfusion in patients with type 2 diabetes. Medicine (Baltimore). 2017;96:e8038 pubmed publisher
    ..05).Hill function-based analysis of Tc-MIBI scintigraphy might be effective method to evaluate earlier lower extremity perfusion changes in diabetic patients. ..
  16. Paraskevas K, Kotsikoris I, Koupidis S, Giannoukas A, Mikhailidis D. Ankle--brachial index: a marker of both peripheral arterial disease and systemic atherosclerosis as well as a predictor of vascular events. Angiology. 2010;61:521-3 pubmed publisher
  17. Wang Y, Xu Y, Hu D, Guo X, Zhao D, Li J. Joint association of ankle-brachial index and serum uric acid on the outcomes of six-year all-cause mortality and cardiovascular mortality in Chinese patients. Int J Cardiol. 2012;158:144-5 pubmed publisher
  18. Peach G, Griffin M, Jones K, Thompson M, Hinchliffe R. Diagnosis and management of peripheral arterial disease. BMJ. 2012;345:e5208 pubmed publisher
  19. Aboyans V, Criqui M, Abraham P, Allison M, Creager M, Diehm C, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012;126:2890-909 pubmed publisher
  20. Ohkuma T, Ninomiya T, Tomiyama H, Kario K, Hoshide S, Kita Y, et al. Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease: An Individual Participant Data Meta-Analysis. Hypertension. 2017;69:1045-1052 pubmed publisher
    ..Thus, measurement of the baPWV could enhance the efficacy of prediction of the risk of development of CVD over that of the Framingham risk score, which is based on the traditional cardiovascular risk factors. ..
  21. Greenland P, Alpert J, Beller G, Benjamin E, Budoff M, Fayad Z, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010;56:e50-103 pubmed publisher
  22. Jongsma H, van Mierlo van den Broek P, Imani F, van den Heuvel D, de Vries J, Fioole B. Randomized comparison of femoropopliteal artery drug-eluting balloons and drug-eluting stents (FOREST trial): Study protocol for a randomized controlled trial. J Vasc Surg. 2017;66:1293-1298 pubmed publisher
    ..5). Secondary end points are technical success, target lesion revascularization, target vessel revascularization, improvement in ankle-brachial index, improvement in Rutherford classification, amputation rate, and mortality rate. ..
  23. Schahab N, Sudan S, Schaefer C, Tiyerili V, Steinmetz M, Nickenig G, et al. Sleep apnoea is common in severe peripheral arterial disease. PLoS ONE. 2017;12:e0181733 pubmed publisher
    ..Long-term results regarding the vasoprotective impact of CPAP treatment on PAD course remains to be determined. ..
  24. Bundó M, Urrea M, Muñoz Ortiz L, Perez C, Llussà J, Forés R, et al. Measurement of the ankle brachial index with a non-mercury sphygmomanometer in diabetic patients: a concordance study. BMC Cardiovasc Disord. 2013;13:15 pubmed publisher
    ..7% were women. The combination of a Doppler device with the hybrid sphygmomanometer is a simple and reliable method to measure ABI showing that hybrid sphygmomanometer is a good alternative to the use of mercury sphygmomanometers. ..
  25. Katakami N, Osonoi T, Takahara M, Saitou M, Matsuoka T, Yamasaki Y, et al. Clinical utility of brachial-ankle pulse wave velocity in the prediction of cardiovascular events in diabetic patients. Cardiovasc Diabetol. 2014;13:128 pubmed publisher
    ..02) increase in AUC (0.72 [95%CI: 0.67-0.78]). Evaluation of baPWV, in addition to carotid IMT and conventional risk factors, improved the ability to identify the diabetic individuals with high risk for CVE. ..
  26. Thomas Manapurathe D, Krishna S, Dewdney B, Moxon J, Biros E, Golledge J. Effect of blood pressure lowering medications on leg ischemia in peripheral artery disease patients: A meta-analysis of randomised controlled trials. PLoS ONE. 2017;12:e0178713 pubmed publisher
    ..Larger multicenter trials with longer anti-hypertensive treatment periods are required to clarify the effect of anti-hypertensives on leg ischemia in PAD patients. ..
  27. Chiang N, Jain J, Sleigh J, Vasudevan T. Evaluation of hyperspectral imaging technology in patients with peripheral vascular disease. J Vasc Surg. 2017;66:1192-1201 pubmed publisher
    ..Its correlation to other established modalities and low interoperator and intraoperator variability could enable this modality to be a useful screening tool in PVD. ..
  28. Heffron S, Rockman C, Adelman M, Gianos E, Guo Y, Xu J, et al. Greater Frequency of Fruit and Vegetable Consumption Is Associated With Lower Prevalence of Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2017;37:1234-1240 pubmed publisher
    ..completed medical and lifestyle questionnaires were evaluated by screening ankle brachial indices for PAD (ankle brachial index ?0.9). Among 3?696?778 individuals, mean age was 64.1±10.2 years and 64.1% were female...
  29. Maesato K, Ohtake T, Mochida Y, Ishioka K, Oka M, Moriya H, et al. Correlation of hippocampal atrophy with hyperhomocysteinemia in hemodialysis patients: An exploratory pilot study. PLoS ONE. 2017;12:e0175102 pubmed publisher
    ..01); while age was an independent determinant of whole-brain atrophy (? = 0.594, R2 = 0.333, P<0.01). In this exploratory pilot study, hippocampal atrophy was significantly correlated with hyperhomocysteinemia in HD patients. ..
  30. Zhang Q, Jiang R, Wang Y, Zhang S, Chen S, Zhang Y, et al. Relation of Ideal Cardiovascular Health Metrics to Asymptomatic Polyvascular Disease in a Chinese Population. Am J Cardiol. 2017;120:393-398 pubmed publisher
    ..In conclusion, we observed a significant inverse gradient association between the number of ideal CVH metrics and prevalence of asymptomatic polyVD. ..
  31. Zheng H, Xu H, Xie N, Huang J, Fang H, Luo M. Association of serum resistin with peripheral arterial disease. Pol Arch Med Wewn. 2013;123:680-5 pubmed
    ..396; P <0.01).  Ln?resistin levels and hsCRP are elevated in PAD patients, and they rise as the severity of PAD increases. A multivariate analysis suggests that Ln?resistin could be a prognostic biomarker for the presence of PAD. ..
  32. Hiatt W. Should an alternate ABI definition be adopted to evaluate risk?. J Am Coll Cardiol. 2013;62:560-1 pubmed publisher
  33. Amrock S, Abraham C, Jung E, Morris P, Shapiro M. Risk Factors for Mortality Among Individuals With Peripheral Arterial Disease. Am J Cardiol. 2017;120:862-867 pubmed publisher
    ..In conclusion, tobacco use increased the risk of all-cause and cardiovascular death, whereas physical activity was associated with a decreased mortality risk. A low ABI and diabetes were also predictive of cardiovascular death. ..
  34. Gomez Marcos M, Recio Rodríguez J, Patino Alonso M, Agudo Conde C, Gómez Sánchez L, Gomez Sanchez M, et al. Cardio-ankle vascular index is associated with cardiovascular target organ damage and vascular structure and function in patients with diabetes or metabolic syndrome, LOD-DIABETES study: a case series report. Cardiovasc Diabetol. 2015;14:7 pubmed publisher
    ..3% were women. Measurements of CAVI, brachial ankle pulse wave velocity (ba-PWV), and ankle brachial index (ABI) were taken using the VaSera device...
  35. Song X, Li G, Qiao A, Chen Z. Association of simultaneously measured four-limb blood pressures with cardiovascular function: a cross-sectional study. Biomed Eng Online. 2016;15:147 pubmed publisher SBP between ?15 and ?20 mmHg, inter-ankle difference in SBP between ?15 and <10 mmHg and right ankle brachial index (RABI) between ?0.9 and ?1.0...
  36. Pandey A, Banerjee S, Ngo C, Mody P, Marso S, Brilakis E, et al. Comparative Efficacy of Endovascular Revascularization Versus Supervised Exercise Training in Patients With Intermittent Claudication: Meta-Analysis of Randomized Controlled Trials. JACC Cardiovasc Interv. 2017;10:712-724 pubmed publisher
    ..Secondary outcomes included resting ankle brachial index (ABI) and treadmill-measured ischemic claudication distance on follow-up...
  37. Wang S, Green L, Motaganahalli R, Wilson M, Fajardo A, Murphy M. Rationale and design of the MarrowStim PAD Kit for the Treatment of Critical Limb Ischemia in Subjects with Severe Peripheral Arterial Disease (MOBILE) trial investigating autologous bone marrow cell therapy for critical limb ischemia. J Vasc Surg. 2017;65:1850-1857.e2 pubmed publisher
    ..If successful, MOBILE could add definitive, high-quality evidence in support of cBMA for the treatment of poor-option CLI patients and provide an additional modality for patients who face amputation secondary to advanced limb ischemia. ..
  38. Deng H, Song Z, Xu H, Deng X, Zhang Q, Chen H, et al. MicroRNA-1185 Promotes Arterial Stiffness though Modulating VCAM-1 and E-Selectin Expression. Cell Physiol Biochem. 2017;41:2183-2193 pubmed publisher
  39. Moyama S, Minami K, Yano M, Okumura M, Hayashi S, Takayama H, et al. Relationship between dietary patterns and brachial-ankle pulse wave velocity among middle-aged adults in Japan. Asia Pac J Clin Nutr. 2017;26:539-544 pubmed publisher
    ..This diet offers an additional nutritional approach to the prevention and treatment of arterial stiffness. ..
  40. Alrouq F, Al Masri A, Al Dokhi L, Alregaiey K, Bayoumy N, Zakareia F. Study of the association of adrenomedullin and basic-fibroblast growth factors with the peripheral arterial blood flow and endothelial dysfunction biomarkers in type 2 diabetic patients with peripheral vascular insufficiency. J Biomed Sci. 2014;21:94 pubmed publisher
  41. Pletcher M, Moran A. Cardiovascular Risk Assessment. Med Clin North Am. 2017;101:673-688 pubmed publisher
    ..These algorithms are the subject of active research and controversy. This article addresses the rationale, current guidelines and use, and potential future directions of cardiovascular risk assessment. ..