DETERMINANTS OF PHYSICAL ACTIVITY IN PERIPHERAL ARTERIAL DISEASE

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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).