Document Detail


Abnormal cardiovascular response to exercise in patients with peripheral arterial disease: Implications for management.
MedLine Citation:
PMID:  16326331     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exercise is beneficial in improving claudication and functional capacity in patients with peripheral arterial disease (PAD). However, the physiologic response during and after exercise testing in this patient population has not been fully described. This study examined the cardiovascular response to exercise and explored the potential contribution of vascular noncompliance to exercise-induced hypertension in 124 patients with PAD and claudication and 31 comparison (C) patients with PAD with no walking limitations. Maximal walking distance was determined by an exercise treadmill test. Heart rate and blood pressure were monitored before, during, and immediately after an exercise test. Vascular compliance of the small and large vessels was measured using pulse waveform analysis. Individuals with low supine resting heart rate had longer pain-free walking distance (r = -0.195, P = .019) and maximal walking versus the C group (62 beats/min, standard deviation [SD] = 10, P = .02). Systolic blood pressure during supine rest was significantly lower for the PAD group (mean = 141 mm Hg, +/- SD = 22) versus the C group (mean = 153 mm Hg, +/- SD = 20, P = .003). Vascular compliance of large vessels was higher in the C group (mean = 4.13 +/- 4.13 mL/mm Hg x 100) compared with the PAD group (mean = 2.95 +/- 1.6 mL/mm Hg x 100). This study describes the exaggerated exercise cardiovascular response and impaired vascular compliance in patients with PAD. These results provide further evidence supporting the importance of a monitored treadmill exercise test before initiation of an exercise program to ensure safe and accurate exercise recommendations, and to identify individuals that require more intensive pharmacotherapy to prevent exercise-induced hypertension and tachycardia.
Authors:
Roberta K Oka; Matt Altman; John C Giacomini; Andrzej Szuba; John P Cooke
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing     Volume:  23     ISSN:  1062-0303     ISO Abbreviation:  J Vasc Nurs     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-05     Completed Date:  2006-02-24     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9014475     Medline TA:  J Vasc Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  130-6; quiz 137-8     Citation Subset:  N    
Affiliation:
University of California San Francisco, Department of Community Health Systems, School of Nursing, San Francisco, California 94143-0608, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arterial Occlusive Diseases / complications,  diagnosis,  physiopathology*
Blood Pressure*
Case-Control Studies
Chi-Square Distribution
Compliance
Exercise Test* / adverse effects,  methods
Female
Heart Rate*
Humans
Hypertension / etiology
Intermittent Claudication / complications,  diagnosis,  physiopathology*
Linear Models
Male
Monitoring, Physiologic
Pain / etiology
Peripheral Vascular Diseases / complications,  diagnosis,  physiopathology*
Pilot Projects
Supine Position
Time Factors
Ultrasonography, Doppler
Vascular Resistance
Walking
Grant Support
ID/Acronym/Agency:
KO1NR00150-01/NR/NINR NIH HHS; P01AI50153/AI/NIAID NIH HHS; R01 HL63685/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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