Early heart disease screening · St. Louis
Finding cardiovascular risk early
Early cardiovascular risk is found by measuring the arteries directly. The ankle-brachial and toe-brachial index, arterial stiffness and pulse waveform analysis show the state of your own circulation, often while peripheral artery disease is still silent.
Blood pressure and cholesterol tell you about inputs. These assessments tell you what those inputs have already done to the vessels.
What does a standard heart risk score miss?
A conventional cardiovascular risk score takes your age, sex, blood pressure, cholesterol, smoking status and diabetes status and estimates a probability. It is genuinely useful and it is an estimate about people like you, not a measurement of you.
The assessments in this suite measure the artery itself. How much pressure is actually reaching the ankle relative to the arm. How rigid the vessel wall has become. What shape the pulse waveform has by the time it reaches a toe. Whether the smallest vessels in the skin still respond. Those are properties of your circulation, not of a population you resemble.
What’s included in a Measura cardiovascular assessment?
Ankle-brachial and toe-brachial index
The ratio of ankle to arm systolic pressure — the standard non-invasive measure of lower-limb arterial disease. The toe index is added because it stays valid when ankle arteries are calcified. Read more
Arterial stiffness
A stiff artery raises the load on the heart and transmits pressure further into small vessels. Read more
Pulse waveform analysis
The shape of the arterial pulse carries information the peak pressure alone does not. Read more
Why test for peripheral artery disease if I feel fine?
Peripheral artery disease is the third most common form of atherosclerotic cardiovascular disease after coronary disease and stroke, and an estimated 202 million people were living with it worldwide in 2010. In the same review, the strongest associations were with current smoking, diabetes, hypertension and high cholesterol — all of which are also reasons someone would be having this assessment in the first place.
The important part is that it is frequently silent. Plenty of people with a measurably abnormal index have never noticed a symptom, because they have unconsciously reduced how far they walk.
What can I do about an abnormal result?
Vascular measurements respond to the things people are usually already being told to do — stopping smoking, treating blood pressure, addressing insulin resistance, walking more. The difference is that with a measurement in hand, you can see whether it worked.
If you are a clinician: the same subject written for the person ordering the test is at the clinical rationale.
Talk to someone about testing
Tell us what you are trying to find out and we will explain which Measura assessments answer that question, what each one involves, and how the results are reviewed with a clinician.
4477 Woodson Rd, Suite 201, St. Louis, MO 63134. Monday to Friday, 9:00 a.m. to 5:00 p.m. Please do not send symptoms, diagnoses or images through a web form — a website form is not a secure medical channel. Send your name and number and we will call you back.
Common questions
Is this the same as a calcium score?
No. A coronary calcium score is a CT scan of the heart’s own arteries. These are non-invasive pressure and waveform measurements of the peripheral circulation, with no radiation. What these assessments measure.
My legs cramp when I walk uphill. Should I be worried?
It is the classic presentation of claudication and it has an objective test. Claudication explained.
I have diabetes and my index came back high. Is that good?
An index above the normal range usually means the arteries are too stiff to compress, which is the opposite of reassuring. Why that happens.
How is a cardiovascular risk assessment done?
A standard risk score plugs your age, sex, blood pressure, cholesterol, smoking and diabetes status into a formula and estimates a probability for people like you. Measura measures you instead: the ankle-brachial and toe-brachial index, arterial stiffness and pulse waveform analysis, all taken non-invasively with no radiation. Those numbers show what the risk factors have already done to your vessels.
What is the first symptom of peripheral artery disease?
Often there is none. Peripheral artery disease is frequently silent, and plenty of people with a measurably abnormal ankle-brachial index have never noticed a thing, because they have quietly cut back how far they walk. When it does show itself, the classic sign is leg cramping when you walk uphill, called claudication, and it has an objective test.
References
- Fowkes FGR, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013;382(9901):1329–1340. doi:10.1016/S0140-6736(13)61249-0
- Aboyans V, Criqui MH, Abraham P, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012;126(24):2890–2909. doi:10.1161/CIR.0b013e318276fbcb
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed .