By Jeffrey S. Eisenberg
The pain in your legs may indicate that your heart is in trouble, especially if you’re diabetic. But, a non-invasive test may help you become more aware of that risk.
An estimated 1 out of 3 diabetic individuals past age 50 develop peripheral arterial disease, or PAD, according to the American Diabetic Association. In patients with PAD, blood vessels in the legs become narrowed or blocked by fatty acids. The result: decreased blood flow to the feet and legs. In peripheral arterial disease, or PAD, occurs when blood vessels in the legs narrowed or become blocked by fatty deposits, decreasing blood flow to the feet and legs.
Although PAD usually affects the legs, it may affect arteries that carry blood to the head, arms, kidneys, and stomach.
Indeed, if you have PAD, you have an increased risk for heart attack, stroke, poor circulation and leg pain. If you’re like many other diabetic patients, however, you may be unaware that you have PAD.
According to the Mayo Clinic, risk factors for PAD in addition to diabetes include history of smoking (current or former smoker), overweight (body mass index of 25 or higher), high blood pressure and high cholesterol.
If you have diabetes and are past age 50, you should particularly have a PAD test. In fact, the American Diabetes Association specifically recommends that people with diabetes past age of 50 have an ABI to test for PAD. People with diabetes younger than 50 may benefit from testing if they have other PAD risk factors. If you’ve already been diagnosed with PAD, your doctor may still want you to have this test to monitor the progress of your treatment.
What is ABI?
Simply put, the ABI compares the blood pressure in your ankle to the blood pressure in your arm. A lower blood pressure reading in the lower part of your leg than in your arm indicates that you may have e narrowing or blockage of the arteries in your legs.
According to the Mayo Clinic, an ABI test is sometimes performed as one of three tests, the others being carotid and abdominal ultrasound to check for blocked or narrowed arteries.
The test typically involves no physical risk other than some temporary discomfort as the blood pressure cuff inflates. As you lie on your back, a technician measures blood pressure in both arms with an inflatable cuff and blood pressure in two arteries in the left ankle using both a blood pressure cuff and a hand-held Doppler ultrasound device that lets the doctor o r technician hear your pulse in your ankle arteries after the cuff is deflated.
What do results mean?
After the test, your doctor calculates ABI by dividing the higher of the two blood pressure measurement of your arms by the higher of the two blood pressure measurements at the arteries near your ankle.
If your ABI score is 1.0 to 1.3, you most likely do not have PAD, although you should still inform your doctor if you have risk factors and continue to be monitored. If your ABI score is 0.8 to 0.99, you have some narrowing of the arteries in the leg, possibly the beginning of PAD. A score of 0.4 to 0.79, you have more significant blockage of your ankle and leg arteries. A score of less than 0.4 indicates significant blockage and severe PAD. Also, a score higher than 1.3 means your arteries are rigid and you may need an ultrasound to check for PAD, as the cuff won’t compress the arteries.
Results may indicate the need for lifestyle changes, medications or surgery to treat peripheral artery disease, according to the Mayo Clinic. Additional imaging tests may also be necessary. Your doctor can talk with you about different options.
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- American Diabetes Association, Mayo Clinic and National Institutes of Health