DETERMINANTS OF PHYSICAL ACTIVITY IN PERIPHERAL ARTERIAL DISEASE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。在表面健康的成年人中，日常体力活动水平低与心血管发病率和死亡率的风险增加有关。对于外周动脉疾病（PAD）受试者来说，久坐不动的不良预后可能会进一步加剧，这些受试者的死亡率已经比没有患外周动脉疾病的人高出11倍。因此，日常体力活动减少和PAD的存在可能会协同作用，将PAD受试者置于后续心血管事件的最高风险组之一。PAD是由于与间歇性跛行相关的行走受限而导致发病的主要原因。间歇性跛行是在截肢过程中，当起搏超过外周循环充分灌注活动下肢肌肉组织的能力时，发生在小腿、大腿或小腿肌群的缺血性肌肉疼痛。由于步行是老年人进行的主要体力活动之一，因此PAD受试者采用久坐不动的生活方式并通常集中在体力活动范围的极低端并不奇怪。事实上，PAD严重程度的测量，如在跑步机测试期间获得的跛行距离和踝/臂指数（ABI）与日常体力活动有关。此外，目前吸烟的PAD受试者比目前不吸烟者采取更多久坐的生活方式。这些结果表明，下肢血管限制的程度和吸烟是PAD受试者日常体力活动的关键决定因素。目的：确定外周动脉疾病（PAD）患者日常体力活动的决定因素。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Low levels of daily physical activity are associated with heightened risk of cardiovascular morbidity and mortality in apparently healthy adults. The poor prognosis of sedentary living may be compounded even further in peripheral arterial disease (PAD) subjects, who already have an 11-fold higher mortality rate than individuals free of PAD. Consequently, the combination of decreased daily physical activity and the presence of PAD may act synergistically to place PAD subjects in one of the highest at-risk groups for subsequent cardiovascular events. PAD is a leading cause of morbidity due to ambulatory limitations associated with intermittent claudication. Intermittent claudication is ischemic muscular pain that occurs in the calf, thigh, or buttock muscle groups during ambulation when the pace exceeds the capacity of the peripheral circulation to adequately perfuse the active lower extremity musculature. Because ambulation is one of the primary physical activities performed by the elderly, it is not surprising that PAD subjects adopt a sedentary lifestyle and typically cluster around the extreme low end of the physical activity spectrum. Indeed, measures of PAD severity, such as claudication distances obtained during a treadmill test and the ankle/brachial index (ABI) are related to daily physical activity. Additionally, PAD subjects who currently smoke adopt a more sedentary lifestyle than current non-smokers. These findings suggest that the extent of vascular limitations in the lower extremities and cigarette smoking are key determinants in daily physical activity in PAD subjects. Purpose: to identify the determinants of daily physical activity in subjects with peripheral arterial disease (PAD).