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Relationship Between Free-Living Daily Physical Activity and Peripheral Circulation in Patients with Intermittent Claudication

Lois A. Killewich, MD, PhD

Leslie I. Katzel, MD, PhD

Christopher J. Womack, PhD

Polly S. Montgomery, MS

Rosemary B. Otis, BS

Tekum Fonong, PhD

Andrew W. Gardner, PhD, FACA

Baltimore Veterans Affairs Medical Center Geriatrics/GRECC (18) 10 North Greene Street Baltimore, MD 21201-1524

The purpose of this study was to determine the relationship between free-living daily physical activity and peripheral circulation under resting, reactive hyperemia, and maximal exercise conditions in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication. Sixty-one PAOD patients (age=70 ±6 years, ankle/brachial index [ABI] =0.57 ±0.24) were recruited from the Vascular Clinic at the Baltimore Veterans Affairs Medical Center and from radio and newspaper advertise ments. Free-living daily physical activity was measured as the energy expenditure of physical activity (EEPA), determined from doubly labeled water and indirect calorimetry. Patients also were characterized on ankle/brachial index, calf blood flow, calf transcutaneous oxygen tension (TcPO₂), and calf transcutaneous heating power (TcHP). ABI and calf blood flow served as markers of the macrocirculation of the lower extremity, while TcPO₂ and TcHP served as markers of the microcirculation. The clau dication patients were sedentary, reflected by a mean EEPA value of 486 ±274 kcal/day. EEPA was related to calf TcHP at rest (282 ±24 mW; r=-0.413, p=0.002), after postoc clusion reactive hyperemia (275 ±22 mW; r=-0.381, p=0.004), and after maximal exercise (276 ±20 mW; r=-0.461, p<0.001). ABI, calf blood flow, and calf TcPO₂ were not related to EEPA under any condition. In conclusion, higher levels of free-living daily physical activity were associated with better microcirculation of the calf musculature in older PAOD patients with intermittent claudication.

Angiology, Vol. 50, No. 4, 289-297 (1999)
DOI: 10.1177/000331979905000404


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