From the Guidelines
The ABI of 1.1 is considered within the normal range, indicating healthy arterial circulation in the lower extremities, as it falls between 1.00 and 1.40, according to the 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease 1. This normal ABI result suggests that there is no significant peripheral arterial disease (PAD) present, and therefore, no specific treatment for PAD is needed. However, it is essential to continue maintaining cardiovascular health through regular exercise, a heart-healthy diet, avoiding smoking, and controlling risk factors like hypertension, diabetes, and cholesterol to ensure long-term vascular health. The ABI is a reliable non-invasive assessment of arterial perfusion, calculated by dividing the highest ankle systolic blood pressure by the highest brachial (arm) systolic blood pressure. Some key points to consider in the interpretation of ABI results include:
- Normal values: 1.00 to 1.40
- Borderline values: 0.91 to 0.99
- Abnormal values: 0.90 or less
- Noncompressible values: greater than 1.40 Given the normal ABI result of 1.1, no further diagnostic testing or treatment is recommended at this time, as stated in the 2024 guideline 1. However, regular monitoring and maintenance of cardiovascular health are crucial to prevent the development of PAD and other cardiovascular diseases.
From the Research
Ankle Brachial Index (ABI) of 1.1
- An ABI of 1.1 is considered to be in the non-diagnostic range for peripheral arterial disease (PAD) in diabetic patients, as values between 0.9 and 1.3 may not accurately reflect the presence or absence of PAD due to arterial medial calcifications 2.
- In non-diabetic patients, an ABI of 1.1 may not be indicative of PAD, as the standard threshold for diagnosing PAD is an ABI of less than 0.9 3, 4.
- However, it is essential to consider the clinical context and other risk factors, such as smoking, hypercholesterolemia, and history of atherothrombotic events, when interpreting ABI results 4, 5.
- The diagnostic accuracy of the ABI may be limited in certain populations, such as those with diabetes, and other methods, such as toe pressure, may be necessary to accurately diagnose PAD 2, 5.
- The use of ABI as a screening tool for PAD has been recommended, but the evidence for its benefits and harms is limited, and more research is needed to determine its effectiveness in improving health outcomes 6.