Heart attacks are one of the leading causes of death globally, with men most at risk after the age of 65 and women at 72. Despite this, many people are unaware of how to assess their heart health and reduce the risk of such life-threatening events. One of the most important steps is understanding whether you have arterial plaque—an often-overlooked factor that significantly contributes to heart attack and stroke risks.
In this article, we explore how to identify arterial plaque at home using a simple technique called the Ankle Brachial Index (ABI), as explained by Dr Ford Brewer, a physician and preventive medicine expert with over 40 years of clinical experience.
Understanding arterial plaque
Many believe that arterial plaque is simply a waxy or fatty substance that lines the inside of blood vessels. However, this is a misconception. Plaque is better described as an inflammatory substance, akin to mucus or snot, that builds up in the walls of arteries. This inflammation, if it ruptures, can spill into the bloodstream, forming large clots. When these clots travel to the heart, they cause heart attacks; if they reach the brain, they result in strokes.
Arterial plaque is often more significant than cholesterol alone in determining heart attack and stroke risks. Therefore, assessing plaque is a critical step in preventive care.
What is the ankle brachial index?
The ABI is a simple test that measures the blood pressure in your arms and ankles. Comparing these readings can reveal whether there is significant arterial plaque obstructing or hardening your arteries. If the blood flow to your legs is compromised due to plaque, it is often an indicator of peripheral artery disease (PAD), which increases the likelihood of heart attacks and strokes.
It is important to note that individuals with deep vein thrombosis (DVT) or severe leg pain should consult a healthcare professional before attempting this test.
Performing the ABI test at home
To perform the ABI test, you will need:
- A blood pressure monitor
- A pen and paper
- A comfortable place to lie down
Follow these steps:
- Rest for several minutes before beginning. Your blood pressure readings can be influenced by movement or stress.
- Measure the systolic blood pressure in your right arm and note the reading. Repeat the process for your left arm.
- Next, measure the systolic blood pressure at your right ankle, ensuring the cuff is placed correctly over the artery. Repeat for your left ankle.
- Record all your readings.
To calculate the ABI, divide the highest systolic reading from your ankles by the highest systolic reading from your arms.
For example:
- If your left ankle reading is 126 and your highest arm reading is 114, divide 126 by 114, resulting in an ABI of 1.1.
Interpreting your results
- Normal range: An ABI of 1.0 to 1.4 indicates healthy arteries.
- Mild issues: An ABI between 0.9 and 1.0 is still acceptable but may warrant further monitoring.
- Concerning results: An ABI below 0.8 suggests significant plaque and potential blood flow obstruction.
- High results: An ABI above 1.4 may indicate arterial hardening, which is another condition that requires medical attention.
Why blood flow in the legs matters
Arteries in the legs face unique challenges, including narrower pathways and reliance on muscle movement to maintain flexibility. By comparing blood pressure in the arms and ankles, the ABI test can detect early signs of arterial issues. PAD, a condition associated with blocked or hardened leg arteries, can cause symptoms such as leg pain, cramps, swelling, and even hair loss. Without sufficient blood flow, tissues in the legs—muscles, nerves, and hair follicles—begin to deteriorate.
What to do next
If your ABI results are within the normal range, congratulations—you are likely on the right track to maintaining heart health. However, even normal results should not be a reason for complacency. Subtle problems may still exist, as severe heart issues can sometimes arise from minor arterial changes.
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For those with concerning results, now is the time to act. Consult a healthcare professional to discuss your findings and explore potential interventions, including lifestyle changes and, if necessary, medications to address plaque buildup.
Prevention is better than cure
The ABI test is an excellent tool for detecting significant arterial problems, but it is just one piece of the puzzle. Heart health is best maintained through a combination of regular physical activity, a balanced diet, and routine check-ups.
Dr Brewer emphasises the importance of lifestyle modifications in reversing or stabilising plaque. Simple steps such as exercising regularly, avoiding prolonged sitting, and adopting a heart-healthy diet can go a long way in reducing risks.
Final thoughts
Heart attacks and strokes often strike unexpectedly, but with preventive measures like the ABI test, individuals can take control of their heart health. By understanding and addressing arterial plaque early, you can reduce the likelihood of life-threatening complications and ensure a healthier future.
Take charge of your heart health today—because prevention is always better than cure.
