Does Your Doctor Take Your Ankle Blood Pressure?

In determining your risk of cardiovascular events, such as a heart attack or stroke, your doctor should also assess the health of your limb arteries; this will give an idea of the health of the arteries supplying the heart muscle or the brain. Using the ratio of the blood pressure in your ankle to that in your arm, one can get a good idea if the leg arteries are narrowed (due to atherosclerotic plaques) or hardened (due to calcification – both of which may affect your chances of having a cardiovascular event. Narrowing is shown by a low ankle:arm blood pressure ratio, while a high ankle:arm pressure ratio suggests hardening, due to calcification.

A study published in the journal Stroke reports on these ratios in almost 3,000 people aged 70 to 79, who were then followed for more than 6½ years. Normal ankle:arm ratios (0.9 to 1.3) were found in 80% of the participants. Low values (below 0.9) were found in 13%, and high values (over 1.3) in 5%. And 2% had non-compressible arteries, i.e no readings could be obtained.

Increased mortality during the follow-up period was found in both the low and high ankle:arm groups. The risks for coronary heart disease could be expressed as 1.4 times and 1.5 times the risk in the normal ratio subjects. Those with non-compressible arteries had an even higher risk of a cardiovascular event – 1.7 times.

What can you do if you know you’re at increased risk? It’s possible to stop further development of atherosclerosis, or even reverse it, by a determined change in lifestyle (exercise, correct nutrition) together with drugs to lower lipid levels.