Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Leg Symptoms, Severity of Peripheral Arterial Disease Predict Functional Decline

29.07.2004


The presence and severity of peripheral arterial disease, as measured by comparing blood pressures in the arm and leg, and the nature of the leg symptoms a patient experiences can be used to identify those at highest risk of decline in walking endurance, according to a study in the July 28 issue of JAMA, the Journal of the American Medical Association.



Peripheral arterial disease (PAD) is a chronic condition that results from narrowing of the vessels that supply oxygen-rich blood to the legs, abdomen, pelvis, arms, or neck. The most commonly affected area is the legs. According to background information in the article, cross-sectional studies demonstrate that distinct types of leg symptoms reported by patients with PAD in the lower extremities are associated with varying degrees of functional impairment. Severity of PAD, as measured by the ankle brachial index (ABI), is also associated with the degree of functional impairment. However, relationships between ABI, leg symptoms, and functional decline are unknown.

A patient is tested for PAD by measuring blood pressure at the ankle and in the arm while the person is at rest, and then repeating both measurements after five minutes of walking on a treadmill. ABI is calculated by dividing the blood pressures measured in the lower leg by the blood pressure measured in the arm. A normal resting ABI is greater than 1.00 or 1.10, and a decrease in ABI with exercise or a resting ABI of < 0.90 are sensitive indicators that significant PAD is probably present.


Mary McGrae McDermott, M.D., of Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a prospective cohort study among 417 people with PAD and 259 without PAD. The participants were age 55 and older, and had baseline functional assessments between October 1, 1998, and January 31, 2000, with follow-up assessments scheduled one and two years afterward. PAD was defined as ABI less than 0.90, and participants with PAD were categorized at baseline into one of five mutually exclusive symptom groups.

The researchers measured annual changes in six-minute walk performance and in usual-paced and fast-paced four-meter walking velocity, adjusted for age, sex, race, prior-year functioning, coexisting diseases, body mass index, cigarette smoking, and patterns of missing data.

“Among 676 men and women age 55 years and older, participants with low ABI levels at baseline had significantly greater decline in walking endurance at two-year follow-up, compared with those with normal baseline ABI levels,” the authors write. “Participants with ABIs less than 0.50 at baseline had a nearly 13-fold increased risk of becoming unable to walk for six minutes continuously two years later, relative to participants with ABIs of 1.10 to 1.50.”

Baseline leg symptoms among participants with PAD also predicted rates of functional decline. “Participants with PAD having leg pain on exertion and rest experienced greater declines in walking endurance and walking speed than did individuals without PAD,” the authors write. “Participants with asymptomatic PAD had significantly greater declines in six-minute walk performance than did participants without PAD.”

“Previously reported lack of worsening in claudication symptoms over time in patients with PAD may be more related to declining functional performance than to lack of disease progression,” they suggest. Claudication is pain in the legs that is typically felt while walking, and subsides with rest.

“Our findings underscore the importance of using the ABI to identify persons with PAD, since PAD is frequently undiagnosed or asymptomatic,” the authors conclude. “Further study is necessary to develop treatments to prevent functional decline in patients with PAD who do not have classic intermittent claudication.”

| newswise
Further information:
http://www.ama-assn.org

More articles from Health and Medicine:

nachricht New malaria analysis method reveals disease severity in minutes
14.08.2017 | University of British Columbia

nachricht New type of blood cells work as indicators of autoimmunity
14.08.2017 | Instituto de Medicina Molecular

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>