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January 5, 1994

Ankle/Arm Blood Pressure Index

JAMA. 1994;271(1):26. doi:10.1001/jama.1994.03510250042025

To the Editor.  —I was interested in the articles on ankle/arm blood pressure index (AAI), measured using a Doppler flow-meter, which most primary care physicians do not own.1-3 The new types of oscillometric sphygmomanometers use no stethoscope but sense the pulse from the air line and give a digital reading. Some even work well on a finger, if it is warm, and would doubtless work on a toe. They are cheap and are sold in drugstores to patients who monitor their own blood pressure. I find they measure ankle blood pressure very accurately.The main error in measuring the AAI is caused by the beat-to-beat and respiratory fluctuations on blood pressure. I attempted to measure both ankle and arm blood pressure simultaneously by connecting one inflation bulb to both instruments. This did not work because the pulsations interacted and gave the same measurement to both.Some manufacturer should be