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Ankle Brachial Index (ABI)

Also known as: ABI or exercise ABI

Duration: About 30 minutes

The ABI is a noninvasive, rapid test that can check for peripheral arterial disease (PAD) by measuring the blood pressures of your ankles and arms. The ABI can be compared before and after walking on a treadmill or riding on a stationary bicycle (known as exercise ABI) to evaluate the degree of stenosis/narrowings. If the ABI is low, it could be indicative of blocked or stenosed peripheral arteries.


  • To check for peripheral artery disease with symptoms (ex: leg pain while walking) or without symptoms
  • If you have a history of diabetes, smoking (or tobacco use), high blood pressure, high cholesterol, and atherosclerosis¬†
  • To follow up after surgery in the blood vessels of you your leg
  • To evaluate the risk of future heart attack or stroke

Preparing for the test: 

Download Pre Test Instructions

How it is performed: 

  • Firstly, you are asked to lie down to relax for a few minutes.
  • The resting blood pressures of both of your ankles and arms will be taken using an inflatable cuff; the readings will be compared in both sides of the body.
  • An ultrasound probe will also be placed against your ankles and arms.
  • Once the cuff is deflated, the ultrasound shows pictures of how well the blood flows in the arteries and the pulse can also be heard.

After the test:

  • Your cardiologist will discuss the results with you.
  • You can continue with your daily routine.
  • Ask your cardiologist if you have any questions or concerns.

Rac-Albu M, Iliuta L, Guberna SM, Sinescu C. The role of ankle-brachial index for predicting peripheral arterial disease. Maedica (Bucur). 2014;9(3):295-302.
Khan TH, Farooqui FA, Niazi K. Critical review of the ankle brachial index. Curr Cardiol Rev. 2008;4(2):101-106. doi:10.2174/157340308784245810
Crawford F, Welch K, Andras A, Chappell FM. Ankle brachial index for the diagnosis of lower limb peripheral arterial disease. Cochrane Database Syst Rev. 2016;9(9):CD010680. Published 2016 Sep 14. doi:10.1002/14651858.CD010680.pub2
Casey S, Lanting S, Oldmeadow C, Chuter V. The reliability of the ankle brachial index: a systematic review. J Foot Ankle Res. 2019;12:39. Published 2019 Aug 2. doi:10.1186/s13047-019-0350-1