Ankle Test Tells Heart Risk After Stroke

ABI Test Detects Asymptomatic Peripheral Artery Disease

By Daniel J. DeNoon
WebMD Health News

Reviewed By Louise Chang, MD

Aug. 27, 2009 -- People with peripheral artery disease (PAD) -- even without symptoms -- have a more than fourfold higher risk of bad outcomes after a transient ischemic attack (TIA) or stroke, a new study suggests.

But the same study finds that a simple test of blood pressure at the ankle can detect asymptomatic PAD, giving patients a chance to reduce their risk.

Heart disease risk goes way up in people who have suffered strokes or TIAs. That risk is even greater in people who also have PAD, a sign that plaque is clogging the arteries.

But some people with PAD don't have any symptoms. Are they, too, at higher risk after a TIA or stroke?

Yes, find Souvik Sen, MD, MPH, of the University of North Carolina, Chapel Hill, and colleagues.

Sen's team used a test called the ankle brachial index (ABI) to detect PAD in 102 patients who had just had a TIA or stroke but had no PAD symptoms (such as pain in the foot, leg, or buttocks after exercise, a symptom called intermittent claudication).

The ABI is a simple test that measures the blood pressure at the ankle and compares it to the blood pressure at the arm. If the ankle blood pressure is significantly lower, it indicates that plaque is clogging the outer arteries of the body. This is PAD.

About a fourth of the TIA/stroke patients in the Sen study did have PAD. Over the next two years, they were four times more likely to suffer a TIA, heart attack, or heart-related death. And they were five times more likely to suffer a stroke.

The ABI test isn't recommended to screen the general population for PAD. But it is advised for people at high risk of PAD.

Now Sen and colleagues suggest that ABI tests may be useful for recognizing risk -- and taking more aggressive steps to lower that risk -- in patients who've recently suffered a stroke or TIA.

The Sen study will appear in a November issue of the American Heart Association journal Stroke.

SOURCES: Sen, S. Stroke, manuscript received ahead of print.

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