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May 12, 2015, last updated June 26, 2016

By Susan M. Callahan, Associate Editor and Featured Columnist

Health and fitness articles are reviewed by our team of Doctors,
Registered Nurses, Certified fitness trainers and other members of
our Editorial Board

Quick question, how many times has your doctor touched
your ankles? If you live in America, the answer very likely is
“never”.  But, for many other people, especially those who
live in France, having your ankles examined is a part of a
standard annual physical.

Why is an ankle exam so important to your health? What
can your doctor discover by examining your ankles?

Why Your Ankle Blood Pressure Is Important

In the US, 7.2% of us over the age of 40 suffers from
“peripheral artery disease”, also called “PAD”.  Other
names for PAD are peripheral vascular disease, peripheral
arterial occlusive disease, and lower extremity artery

Peripheral artery disease means what it sounds like –the
arteries in the periphery of your body don't get enough
blood.   By “periphery”,  we  mean the parts of your body
farthest from your heart—your hands, feet and limbs.  
Because with peripheral artery disease, warm blood does
not reach your outer limbs,  you experience a range of
symptoms, including cold feet and hands.

In all cases of PAD, your
peripheral arteries are partially or
totally blocked.

Most importantly, if you have PAD, you are much more
likely to die from
cardiovascular problems as someone who
does not have PAD. Some studies estimate that you are
twice as likely to die.

But others such as 2006 study from a consortium of
scientists around the world led by Dr. F.G.R. Fowkes of the
University of Edinburgh from estimates that, if you have
PAD, you are 6 times more likely to die from cardiovascular

Who Gets PAD?

Pad occurs mostly among people over age 50. People who
smoke are most at risk fro PAD. People with diabetes have
PAD twice as much as non-diabetics. In the US, between
12% and 20% of all people have PAD, according to the
CDC.  In the UK, 20% of all men over 50 have PAD and
12.5% women over 50 have it, according to the National
Health Service.

But anyone whose lifestyle predisposes them to
cardiovascular disease are at risk for PAD –smokers, those
who eat a high-saturated fat Western diet, those who are

Your ankle blood pressure is important because it is the
way that doctors determine whether you have PAD.  If the
blood pressure at your ankles is less than “1”, you should
worry. If your ankle blood pressure is .9, you officially
have PAD.

Ankle blood pressure less than .9 also indicates a
“generalized asymptomatic artheriosclerotic disease” ---
clogged and hardened  arteries throughout your body---
according  to a 2009 study from the Atrium Medical Center
Parkstad, Heelen in the Netherlands.

Your Ankle Blood Pressure — the Ankle Brachial Index

Most of us labor under a misconception that we have a
single “blood pressure” that is the same all over our
bodies. But the truth is that your blood pressure actually is
different, depending on where on your body it is taken.
After all, blood pressure exists wherever you have a pulse
on your body --- your arms, neck and indeed your ankles.

The standard way to take blood pressure is to squeeze a
cuff around your upper arm. But that's only half the story
when it comes to blood pressure. You should also have
your ankle pressure taken. Then, doctors will compare the
two and determine your ankle brachial index.

Symptoms of Inadequate Ankle Blood Pressure

The most common symptom that you have too low ankle
blood pressure and PAD is pain in your legs when you
exercise. If this pain in your leg stops when you stop
exercising, you may have PAD.

Natural Remedies That Help

What can you do to help prevent PAD?  Fortunately, we
have found certain remedies that can actually reduce your
risk for PAD. Here are the Top 7:

Don't Smoke

Smoking is the main risk factor for peripheral artery
disease. People who smoke are 2 to 6 times more likely to
have PAD, according to the US Centers for Disease Control.

Make Sure You Get Enough Zinc in Your Diet

Adequate levels of dietary zinc are correlated with low
rates of peripheral artery disease. After measuring the
levels of dietary zinc in a population of South Koreans with
and without arterial disease, scientists from HangYang
University discovered in 2010 that those with the lowest
levels of zinc also had the highest rates of arterial disease.  
The doctors theorized that zinc may offer a protective
effect against arterial disease, though how it achieves this
is not yet clear.

In the US, our diets are chronically low in zinc. To get more
zinc into your diet, try eating oysters.

A single oyster contains about 5 milligrams of  zinc, about
half the minimum daily recommended amount of 11
milligrams for adult men and 8 milligrams for adult women
set by the US National Institute of Health. In the UK, the
recommended daily intake of zinc is lower, 9.5 milligrams
for adult men and 7 for adult women.  Watch your iron
intake if you're low on zinc –iron interferes with your
body's ability to absorb zinc.

Eat Foods Rich in Fiber

Eating a diet rich in fiber will lower your risk for artery
disease, several university studies have found.

A 2007 study from Wake Forest University School of
Medicine studied 1178 people and compared these results
with an ultrasound examination of the thickness of their
carotid arteries.  They discovered that people who eat fiber
–cooked cereals such as oatmeal, whole grain breads, cold
whole grain cereal – had the lowest risk for arteriosclerosis.

And here's the kicker. This was true no matter what the
other components of their diets were or no matter what
their individual risk profiles were.  

As we've said before, there really is perhaps no more heart-
protective life style changes you can make is to include
whole grains and fiber in your diet, particularly oatmeal.  

Not everyone is as enthusiastic. The American Society of
Nutrition takes a conservative view that  eating cereal fiber
and whole grains is “modestly associated” with a reduced
risk of artery disease.

Lose Weight to Stave Off PAD

Maintaining a healthy body weight is important for
preventing artery disease.

Each pound of body weight raises the load on your heart
by about 1%. So, losing 5 pounds can help to decrease the
“work” your heart must do to pump blood by about 5%.

Carrying around extra weight not only increases the work
your heart must do to pump blood to your outer limbs but
it also compresses the arteries in your lower legs.

Maintain Healthy Blood Pressure

High blood pressure is a high risk factor for peripheral
artery disease. From 50% to 92% of people with PAD have
high blood pressure.

Here, the cause and effect are not clear – does PAD cause
high blood pressure or does high blood pressure cause
PAD?  In either event, keeping your blood pressure at
normal levels significantly reduces your risk for PAD,
according to a 2010 study from Mount Sinai School of

Maintain Normal Blood Sugar Levels—Avoid Diabetes

Diabetes puts you at higher risk for PAD. Diabetics are
between 1.5 and 4 times higher risk for PAD, according to
the 2010 Mount Sinai study.  

Avoiding diabetes requires a full lifestyle approach ---
eating a low glycemic diet, staying active and maintaining a
healthy body weight.  

Here is a list of
foods that help you to maintain normal
blood sugar levels
for up to 10 hours each day. And here
10 simple ways to become more active in your every
day life.

Take Aspirin?

The scientific community is divided on this issue of whether
aspirin helps.  Many people believe that taking an aspirin
helps to stave off arteriosclerosis and PAD.

However, some scientists have found that the opposite is
true. In people who show no symptoms --- asymptomatic
PAD --- 91 scientists from the collaboration led by Dr.
Fowkes of the University of Edinburgh in 2010 discovered
there was no difference in cardiovascular risk between
people who took a 100 gram aspirin a day and those who
did not. A 2014 study led by Dr. Y. Ikeda of Waseda
University in Tokyo, Japan found the same result.

But the 2010 Mount Sinai study disagrees, citing other
studies which recommend that people with PAD take aspirin.


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