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Cardiolucent

Procedure

EndoPAT — Noninvasive Endothelial Function Testing

A noninvasive in-office test that measures the health of the endothelium — the inner lining of the blood vessels and the earliest tissue to show signs of cardiovascular disease.

What it is

The earliest measurable sign of vascular dysfunction.

The endothelium is the single-cell-thick lining of every blood vessel in the body. It is the first tissue affected by the metabolic, inflammatory, and oxidative stresses that lead to atherosclerosis — endothelial dysfunction can be measured years before plaque builds up, before lipid panels turn abnormal, and before any imaging study shows disease. EndoPAT is the FDA-cleared, noninvasive test that quantifies endothelial function via peripheral arterial tonometry. The result — a Reactive Hyperemia Index (RHI) score — is a sensitive marker of vascular health that responds to lifestyle and pharmacologic interventions, making it useful both for risk stratification and for tracking treatment response.

Quiet room, fingertip probes, 15 minutes.

You rest in a comfortable recliner with small probes placed on the tips of both index fingers. A blood pressure cuff inflates on one arm for five minutes to occlude flow, then releases. The test measures how well the artery dilates in response to the released flow — a direct functional readout of endothelial nitric oxide production. The whole exam takes about 15 minutes; results are available immediately and reviewed with you before you leave.

Patients who want to know — before disease is visible.

EndoPAT is particularly useful for adults with strong family history of premature cardiovascular disease, patients with metabolic syndrome or insulin resistance whose traditional cardiac testing is still normal, anyone tracking the effect of lifestyle change or risk-reduction medication, patients with unexplained symptoms (chest discomfort, exercise limitation) where the standard workup is clean, and as a baseline for younger patients beginning concierge cardiology care.

Common Questions

Frequently Asked Questions

Do I need to do anything to prepare?
Avoid caffeine, nicotine, and a large meal for at least 4 hours beforehand — all three can affect vascular tone and skew the result. Hold short-acting nitrates if you take them, per Dr. Kedan's specific instructions.
How long does the test take?
About 15 to 20 minutes including setup. You'll sit comfortably in a recliner; no needles, no contrast, no radiation.
What does the result mean?
The Reactive Hyperemia Index (RHI) is reported as a continuous score. Values below 1.67 are typically considered abnormal and correlate with increased future cardiovascular event risk in published cohorts; values comfortably above that threshold are reassuring. Dr. Kedan walks you through your specific number in the context of your overall picture.
Is the test repeatable to track progress?
Yes — that's one of its key uses. Endothelial function responds to lifestyle change (exercise, weight loss, dietary patterns) and certain medications (statins, ACE inhibitors, GLP-1s) within weeks to months. Serial EndoPAT testing is a direct way to confirm that an intervention is actually improving vascular biology, not just lab numbers.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.