Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men

Planas, A.; Clarà, Albert Benet i; Pou, J. M.; Vidal-Barraquer, F.; Gasol, Ana; Moner, A. De; Contreras, Carmen; Marrugat, Jaume

doi:10.1038/sj.ijo.0801638

Cited by 68 publications

(37 citation statements)

References 18 publications

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“…A previous study reported a relationship between abdominal adiposity and PAD 23,24) . WC may be associ- Receiver operating characteristic curves of PAD from the selected models (Table 3) for 900 male ( Fig.…”

Section: Discussionmentioning

confidence: 93%

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Risk Factors for and the Prevalence of Peripheral Arterial Disease and its Relationship to Carotid Atherosclerosis: The Kyushu and Okinawa Population Study (KOPS)

Ohnishi

Sawayama

Furusyo

et al. 2010

JAT

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Section: Discussionmentioning

confidence: 93%

“…Age and dyslipidemia were associated with most of the previously reported conventional risk factors for PAD-related factors 5,[8][9][10] ; however, few studies have reported WC as an independent risk factor for PAD 23,24) . A previous study reported a relationship between abdominal adiposity and PAD 23,24) .…”

Section: Discussionmentioning

confidence: 93%

Risk Factors for and the Prevalence of Peripheral Arterial Disease and its Relationship to Carotid Atherosclerosis: The Kyushu and Okinawa Population Study (KOPS)

Ohnishi

Sawayama

Furusyo

et al. 2010

JAT

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“…26,27 The discrepancy may be related to the higher prevalence of PAD in elderly males and in smokers; elderly males show a weaker relationship between obesity and CVD, and smokers tend to have lower BMI than non-smokers. 28 A recent prospective cohort study revealed a positive relationship between waist-to-hip ratio, not BMI, and PAD prevalence. 29 Mechanisms by which obesity may cause PAD (if any) could be different to those for CHD, as they do have different risk profiles (eg, cigarette smoking is more strongly associated with the development of PAD than CHD).…”

Section: Peripheral Arterial Disease (Pad)mentioning

confidence: 98%

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Shimabukuro

2009

Circ J

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he obesity epidemic is a global public health concern that threatens to reduce life expectancy around the world. 1,2 Excess weight, particularly abdominal obesity, causes or exacerbates cardiovascular and metabolic risk factors, including hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM). [3][4][5] These risk factors synergistically increase the likelihood of morbidity and mortality of cardiovascular disease (CVD), 6,7 which leads to rising healthcare costs. 8 Actions promoting health check-ups for obesity-related conditions and prevention strategies have been proposed; 9 however, the theoretical background has not been fully coordinated, and, most importantly, the actions to reduce abdominal adiposity has not been fully validated in terms of global cardiovascular risk management. The contribution of abdominal obesity to global cardiometabolic risk will be reviewed and the potential, underlying mechanisms and management strategy will be also discussed. Contribution of Abdominal Obesity to CVDRecent studies show that waist circumference is directly related to all-cause mortality when adjusted for body mass index (BMI), 6 and is also strongly associated with the mortality and morbidity of CVD. 7 The facts highlight the importance of visceral fat over subcutaneous fat deposits and promote the incorporation of waist circumference into the diagnosis of metabolic syndrome (MetS). 3-5 Each entity of CVD will be discussed below. Coronary Heart Disease (CHD)In the landmark INTERHEART study, 10 Yusuf et al reported the effect of various measures of adiposity on rates of acute myocardial infarction (AMI) by comparing 12,461 AMI cases and 14,637 standardized controls of varying ethnicity from 52 countries. BMI showed a modest association with AMI (unadjusted odds ratio (OR) 1.44 for 1 st vs 5 th quintile), but this association was lost after adjustment for other risk factors. Meanwhile, the adjusted OR for quintile of the waist-to-hip ratio was successively greater than that of the previous one (OR 1.15, 1.39, 1.90, and 2.52, respectively). Waist-to-hip ratio, and the waist and hip circumferences were highly associated with the risk of AMI, even after adjustment for other risk factors (OR for 1 st vs 5 th quintiles, 1.75, 1.33, and 0.76, respectively; P<0.0001). More recently, investigators in the EPIC-Norfolk study reported that waist circumference, but not BMI, was a significant estimate for all CHD events during 9.1 years and that hip circumference appeared to protect against CHD. 11 Taken together, a redefinition of obesity based on waist circumference, instead of BMI, is a better estimate of CHD in most ethnic groups, and the notion can be supported that abdominal adiposity, not subcutaneous adiposity, is closely linked to the onset of CHD. The presence of MetS appears to be associated with worse outcomes in patients with AMI 12 or in patients following coronary artery bypass surgery. 13 In subjects with angiographically normal coronary arteries, acetylcholine-induced coronary vasoconstriction correlated ...

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“…Obesity is usually observed in PAD patients [7] . Nevertheless, although the effects of obesity and PAD decreasing exercise tolerance and compromising vascular function have been well defined [4,8] , the effects of their associations on these aspects are not well documented.…”

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confidence: 99%

Obesity Decreases Time to Claudication and Delays Post-Exercise Hemodynamic Recovery in Elderly Peripheral Arterial Disease Patients

Ritti‐Dias¹,

Forjaz²,

Cucato³

et al. 2008

Gerontology

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Background: Althoughobesity is usually observed in peripheral arterial disease (PAD) patients, the effects of the association between these diseases on walking capacity are not well documented. Objective: The main objectives of this study were to determine the effects of obesity on exercise tolerance and post-exercise hemodynamic recovery in elderly PAD patients. Methods: 46 patients with stable symptoms of intermittent claudication were classified according to their body mass index (BMI) into normal group (NOR) = BMI <28.0 and obese or in risk of obesity group (OBE) = BMI ≥28.0. All patients performed a progressive graded treadmill test. During exercise, ventilatory responses were evaluated and pre- and post-exercise ankle and arm blood pressures were measured. Results: Exercise tolerance and oxygen consumption at total walking time were similar between OBE and NOR. However, OBE showed a lower claudication time (309 ± 151 vs. 459 ± 272 s, p = 0.02) with a similar oxygen consumption at this time. In addition, OBE presented a longer time for ankle brachial index recovery after exercise (7.8 ± 2.8 vs. 6.3 ± 2.6 min, p = 0.02). Conclusion: Obesity in elderly PAD patients decreased time to claudication, and delayed post-exercise hemodynamic recovery. These results suggest that muscle metabolic demand, and not total workload, is responsible for the start of the claudication and maximal exercise tolerance in PAD patients. Moreover, claudication duration might be responsible for the time needed to a complete hemodynamic recovery after exercise.

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Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men

Cited by 68 publications

References 18 publications

Risk Factors for and the Prevalence of Peripheral Arterial Disease and its Relationship to Carotid Atherosclerosis: The Kyushu and Okinawa Population Study (KOPS)

Risk Factors for and the Prevalence of Peripheral Arterial Disease and its Relationship to Carotid Atherosclerosis: The Kyushu and Okinawa Population Study (KOPS)

Cardiac Adiposity and Global Cardiometabolic Risk New Concept and Clinical Implication

Obesity Decreases Time to Claudication and Delays Post-Exercise Hemodynamic Recovery in Elderly Peripheral Arterial Disease Patients

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