Patients With Peripheral Arterial Disease With Exaggerated Pressor Response Have Greater Ambulatory Dysfunction Than Patients With Lower Pressor Response

Abstract

We determined whether patients with peripheral arterial disease (PAD) who have either an exaggerated or a negative pressor response during treadmill walking have shorter peak walking time (PWT) and claudication onset time (COT) than patients with a normal pressor response, independent of comorbid conditions. A total of 249 patients were categorized to 1 of 3 groups based on systolic blood pressure (SBP) responses at 2 minutes of treadmill walking (speed = 2 mph, grade = 0%): group 1 (negative pressor response, SBP < 0 mm Hg), group 2 (normal pressor response, SBP 18 mm Hg), and group 3 (exaggerated pressor response, SBP > 18 mm Hg). After adjusting for comorbid conditions, group 3 (exaggerated) had significantly reduced COT ( P = .011) and PWT ( P = .002) compared to group 2 (normal), while group 1 (negative) and group 2 (normal) were not different. Patients with symptomatic PAD with an increase in SBP > 18 mm Hg after 2 minutes of treadmill walking experience claudication earlier and thus have greater ambulatory dysfunction, compared to patients with PAD with a normal pressor response, whereas patients with PAD with negative pressor response had a similar walking performance. The implication is that the magnitude of pressor response to only 2 minutes of treadmill walking can partially explain the degree of ambulatory dysfunction in patients with PAD.

Acute effects of leg heat therapy on walking performance and cardiovascular and inflammatory responses to exercise in patients with peripheral artery disease

“…The reduction in resting BP after HT was partially sustained throughout the exercise bout and during the recovery period. This finding also holds potential clinical significance because elevated exercise BP is linked to ambulatory dysfunction (Kim et al., 2020b) and is a strong independent risk factor for all‐cause long‐term mortality in people with PAD (Liefde et al., 2008). However, it is important to note that when expressed relative to pre‐exercise levels, the increase in BP during exercise was similar following HT and CON.…”

Alterações Longitudinais nos Níveis de Atividade Física e Parâmetros de Risco Cardiovascular em Pacientes com Doença Arterial Periférica Sintomática

“…As associações entre as alterações delta (valores após 2 anos -valores da linha de base) na atividade física e nos parâmetros cardiovasculares foram analisadas por regressão linear múltipla ajustada para sexo, idade, mudanças na medicação anti-hipertensiva, ITB, peso e capacidade de caminhada, que são fatores de confusão clássicos na DAP. [17][18][19][20] A análise residual foi realizada. A homocedasticidade foi analisada por análise gráfica (scatterplot), e a aderência à distribuição normal foi testada pelo teste de Kolmogorov-Smirnov.…”