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.
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