BACKGROUND: Recent studies indicate that the use of ankle-brachial index (ABI) measurements helps identify patients with peripheral arterial disease. Previous research also reveals a relationship between peripheral arterial disease and higher incidence of cardiac mortality and morbidity. PURPOSE: The purpose of this study was to investigate the correlation of a low ABI (<0.90 mm Hg) with coronary artery disease, diabetes, hypercholesterolemia, body mass index greater than 25, a sedentary lifestyle, smoking, and carotid artery disease. METHODS: A descriptive correlational design was used to study a population (N = 810) of fairly healthy women who self-selected to undergo cardiovascular screening that they paid for out of pocket. Cardiac disease and most of the data on risk factors were obtained using questionnaires. Carotid artery stenosis was determined by ultrasound. Hypotheses were tested using χ and independent t test. RESULTS: A statistically significant relationship was found between a low ABI and the presence of moderate to severe carotid artery stenosis (χ = 5.90, P = .015). A low ABI (<0.90 mm Hg) was not significantly related to cardiac disease (χ = 0.83, P = .362), diabetes (χ = 1.82, P = .177), hypercholesterolemia (χ = 0.01, P = .930), claudication (χ = 2.06, P = .151), physical activity (χ = 1.17, P = .884), or body mass index (t = 1.12, P = .270). CONCLUSION: The significant relationship between low ABI and carotid artery stenosis illustrates that atherosclerosis occurs in multiple arterial beds simultaneously. The lack of association between ABI and the other variables probably reflects the self-report nature of the data collected on these variables. Ankle-brachial index measurements may be useful in future research as a tool for early recognition of cardiovascular disease.