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welcome to a Stanford medicine 25 video on ankle brachial index hi Im John Cooke Im a professor of medicine in the division of cardiovascular medicine here at Stanford and today Im going to show you how to detect proof our tool disease in the office setting using the ankle brachial index which is simply a measure of ankle pressure divided by the pressure at the arm the brachial pressure about 8 million people in the country with profe arterial disease but only about 30% have been diagnosed but with a simple handheld Doppler and a blood pressure cuff measurements at the ankle and at the arm can give you an ankle brachial index to tell you whether or not the person in your office has prefer our Childers ease everyone over the age of 60 and anyone over the age of 50 thats diabetic or smoker should have this test done to determine if they have prior to these because we have life and limb saving medical therapies for these individuals like ACE inhibitors and statins and antiplatelet age