The ankle-brachial pressure index ( ABPI ) or ankle-brachial index ( ABI ) is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to peripheral artery disease (PAD). The ABPI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure in the arm.
15-543: ABPI may refer to: Ankle-brachial pressure index , a measure of the fall in blood pressure in the arteries supplying the legs Association of the British Pharmaceutical Industry , the trade association for companies in the UK producing prescription medicines Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with
30-443: A high calcium/vitamin D ratio. This can occur with or without a mineral imbalance. A common misconception is that calcification is caused by excess amount of calcium in diet . Dietary calcium intake is not associated with accumulation of calcium in soft tissue, and calcification occurs irrespective of the amount of calcium intake. Intake of excessive vitamin D can cause vitamin D poisoning and excessive intake of calcium from
45-423: A lesser than 0.9 indicates arterial disease. An ABPI value of 1.3 or greater is also considered abnormal, and suggests calcification of the walls of the arteries and incompressible vessels, reflecting severe peripheral vascular disease . Provided that there are no other significant conditions affecting the arteries of the leg, the following ABPI ratios can be used to predict the severity of PAD as well as assess
60-405: A normal subject the pressure at the ankle is slightly higher than at the elbow (there is reflection of the pulse pressure from the vascular bed of the feet, whereas at the elbow the artery continues on some distance to the wrist). The ABPI is the ratio of the highest ankle to brachial artery pressure. An ABPI between and including 0.90 and 1.29 considered normal (free from significant PAD ), while
75-440: A standard part of the aging process. Nearly all adults show calcification of the pineal gland . In a number of breast pathologies , calcium is often deposited at sites of cell death or in association secretions or hyalinized stroma, resulting in pathologic calcification. For example, small, irregular, linear calcifications may be seen, via mammography , in a ductal carcinoma-in-situ to produce visible radio-opacities. One of
90-410: Is noteworthy that abnormal values of ABI predispose to development of the frailty syndrome . Calcification Calcification is the accumulation of calcium salts in a body tissue . It normally occurs in the formation of bone , but calcium can be deposited abnormally in soft tissue , causing it to harden. Calcifications may be classified on whether there is mineral balance or not, and
105-501: The ABI is a fast, accurate, and painless exam, however these issues have rendered ABI unpopular in primary care offices and symptomatic patients are often referred to specialty clinics due to the perceived difficulties. Technology is emerging that allows for the oscillometric calculation of ABI, in which simultaneous readings of blood pressure at the levels of the ankle and upper arm are taken using specially calibrated oscillometric machines. In
120-542: The Doppler wand, the inflation continues until the pulse in the artery ceases. The blood pressure cuff is then slowly deflated. When the artery's pulse is re-detected through the Doppler probe the pressure in the cuff at that moment indicates the systolic pressure of that artery. The higher systolic reading of the left and right arm brachial artery is generally used in the assessment. The pressures in each foot's posterior tibial artery and dorsalis pedis artery are measured with
135-427: The head or any extremities dangling over the edge of the table. Measurement of ankle blood pressures in a seated position will grossly overestimate the ABI (by approximately 0.3). A Doppler ultrasound blood flow detector, commonly called Doppler wand or Doppler probe, and a sphygmomanometer (blood pressure cuff) are usually needed. The blood pressure cuff is inflated proximal to the artery in question. Measured by
150-468: The higher of the two values used as the ABI for that leg. The ABPI test is a popular tool for the non-invasive assessment of Peripheral vascular disease (PVD). Studies have shown the sensitivity of ABPI is 90% with a corresponding 98% specificity for detecting hemodynamically significant ( stenosis of more than 50%) in major leg arteries, defined by angiogram. However, ABPI has known issues: When performed in an accredited diagnostic laboratory,
165-426: The intestine which, when accompanied by a deficiency of vitamin K (perhaps induced by an anticoagulant ), can result in calcification of arteries and other soft tissue. Such metastatic soft tissue calcification is mainly in tissues containing "calcium catchers" such as elastic fibres or mucopolysaccharides . These tissues especially include the lungs (pumice lung) and the aorta. Calcification can be pathological or
SECTION 10
#1732854958825180-809: The location of the calcification. Calcification may also refer to the processes of normal mineral deposition in biological systems, such as the formation of stromatolites or mollusc shells (see Biomineralization ). Calcification can manifest itself in many ways in the body depending on the location. In the pulpal structure of a tooth, calcification often presents asymptomatically, and is diagnosed as an incidental finding during radiographic interpretation. Individual teeth with calcified pulp will typically respond negatively to vitality testing; teeth with calcified pulp often lack sensation of pain, pressure, and temperature. Calcification of soft tissue (arteries, cartilage, heart valves , etc.) can be caused by vitamin K 2 deficiency or by poor calcium absorption due to
195-536: The nature and best management of various types of leg ulcers . Studies also indicate that the assessment of PAD in people with diabetes should use both ABPI ratios and Doppler waveforms. Studies in 2006 suggests that an abnormal ABPI may be an independent predictor of mortality, as it reflects the burden of atherosclerosis . It thus has potential for screening for coronary artery disease , although no evidence-based recommendations can be made about screening in low-risk patients because clinical trials are lacking. It
210-434: The principal causes of arterial stiffening with age is vascular calcification. Vascular calcification is the deposition of mineral in the form of calcium phosphate salts in the smooth muscle-rich medial layer of large arteries including the aorta. DNA damage , especially oxidative DNA damage, causes accelerated vascular calcification. Vascular calcification could also be linked to the chronic leakage of blood lysates into
225-498: The title ABPI . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=ABPI&oldid=721993022 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Ankle-brachial pressure index The patient must be placed supine, without
#824175