. Tsai JC, Chan P, Wang CH, Jeng C, Hsieh MH, Kao PF, Chen YJ, Liu JC (Taipei Medical University‐Wan Fang Hospital, Taipei, Taiwan). The effects of exercise training on walking function and perception of health status in elderly patients with peripheral arterial occlusive disease. J Intern Med 2002; 252: 448–455. Objective. To determine the effects of 12‐week exercise programme on ambulatory function, free‐living daily physical activity and health‐related quality of life in disabled older patients with intermittent claudication. Design. Prospective, randomized controlled trial. Setting. University Medical Center and Veterans Affairs Medical Center, Taipei, Taiwan. Subjects. Thirty‐two of 64 patients with Fontaine stage II peripheral arterial occlusive disease (PAOD) were randomized to exercise training and 32 to usual care control. Five patients from the exercise group and six patients from the control group dropped out, leaving 27 and 26 patients, respectively, completing the study in each group. Interventions. Twelve weeks of treadmill exercise training. Main outcome measures. Treadmill walking time to onset of claudication pain and to maximal claudication pain, 6‐min walk distance, self‐reported ambulatory ability and perceived health‐related quality of life (QOL). Results. Compliance of exercise programme was 83% of the possible sessions. Exercise training increased treadmill walking time to onset of claudication pain by 88% (P < 0.001), time to maximal pain by 70% (P < 0.001), and 6‐min walk distance by 21% (P < 0.001). Subjects. Perception of health‐related QOL improved from 12% to 178% in the exercise group. These improvements were significantly better than the changes in the control group (P < 0.05). Conclusions. Significant improvements in claudication following 12‐week exercise training in elderly PAOD patients were observed. Increase in treadmill walking time to maximal claudication pain in these patients translated into the improvement of perceived physical health, which enabled the patients to become more functionally independent.

These data, which are clinically significant, suggest that 12 weeks of exercise training can result in successful reduction of BP and favorable changes in the lipid profile that would be beneficial to patients with white coat hypertension.

This study performed beat-to-beat and spectral analyses of 20-minute skin-surface laser-Doppler-flowmetry (LDF) and radial blood-pressure-waveform (BPW) signals in order to compare the blood-flow perfusion condition and regulatory mechanisms between essential-hypertension (EHT) patients and aged-matched control subjects. Beat-to-beat LDF analyses yielded the pulse width (PW), AC-to-DC ratio (AD), and their corresponding variability indices (coefficients of variation [CVs]). The relative energy contributions (RECs) of five characteristic frequency peaks (defined as FR1–FR5) were also calculated. Spectral BPW analysis obtained the amplitude proportion (C n ) and phase angle (P n ) of each harmonic component n. PW, AD, AD_CV, and REC of FR2 were significantly smaller in the EHT group than in the control group. Regarding BPW indices, C 1, C 2, C 4, and C 5 were significantly larger and P 2–P 8 were significantly smaller in EHT patients than in controls. The present results indicate that BPW and LDF indices can be used to evaluate the blood-flow perfusion efficiency and microcirculatory regulatory activities in EHT. Sex differences were found, with the effects being more prominent in female patients. These findings may be partly attributable to impairment of endothelial and neural regulatory functions. The present findings might aid the development of new noninvasive methods for reducing the risk of EHT-induced damage.

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