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 The genes are not to blame
20.07.2018 | Technische Universität München

nachricht Targeting headaches and tumors with nano-submarines
20.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

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: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>