title: Lower limb atherosclerotic disease causes various deteriorations of patients' health-related quality of life.
abstract: BACKGROUND
  Lower limb atherosclerotic disease (LLAD) is a worldwide health problem. Approximately 100,000 Finns have LLAD. Currently, a large number of health-related quality of life (HRQoL) studies are available, but we still have scant comprehensive information of HRQoL of patients with LLAD.
  
  
  OBJECTIVE
  The aim was to describe the HRQoL of women and men with LLAD in relation to the age- and sex-matched general population. In addition, the purpose was to study which demographic and relevant clinical and psychologic factors are connected with HRQoL of patients with LLAD.
  
  
  METHODS
  Patients with LLAD (N = 180, 62 women and 118 men) were recruited to participate in this study in the Clinic of Surgery, Oulu University Hospital, from 2001 to 2004. The control sample consisted of an age- and sex-matched general population (N = 2126; 1081 women and 1045 men). The HRQoL of the women and men with LLAD was evaluated using the Nottingham Health Profile (NHP) instrument, in relation to an age- and sex-matched general population (N = 2126) as well as demographic and relevant clinical and psychologic factors.
  
  
  RESULTS
  The HRQoL of men was significantly (P < .05) poorer on all dimensions of the NHP instrument in the age groups 55 to 74 years. HRQoL was also clearly affected in the youngest age group of men on the dimensions of pain (P < .05) and mobility (P < .05) and further in the oldest age group on the dimension of energy (P < .05). The HRQoL of women with LLAD was only significantly poorer (P < .05) on the dimension of pain in the age group of 65 to 74 years than the HRQoL of age-matched Finnish women. The most emphasized relationships between poor HRQoL and the demographic, relevant clinical and psychologic factors were male sex, lack of exercise, retirement, a short painless walking distance, other atherosclerotic disease, poor subjective health status, problems with ability to cope at home, problems with the treatment of illness, and sex life. Male patients with LLAD had poorer HRQoL than the corresponding female patients on the dimensions of energy (P = .023), emotional reaction (P = .050), social isolation (P = .028), and NHP total score (P = .023). Those who did not exercise regularly had poorer HRQoL on the dimensions of energy (P = .005), pain (P = .049), emotional reaction (P = .007), social isolation (P = .001), and physical mobility (P = .028) than those who did exercise regularly.
  
  
  CONCLUSIONS
  The HRQoL of middle-aged men was significantly poorer than that of controls. Male sex, retirement, asymptomatic walking distance, other atherosclerotic disease, lack of exercise, and feeling incapable of performing daily activities are important causes of impaired HRQoL. Health care professionals should pay extra attention to the development of rehabilitation programs aimed at preventing patients with LLAD from experiencing a myriad of problems.
authors.affiliation: Department of Nursing Science and Health Administration, Faculty of Medicine, University of Oulu, Oulu, Finland. kirsi.koivunen@oulu.fi
authors.forename: Kirsi
authors.initials: K
authors.lastname: Koivunen
authors.forename: Hannele
authors.initials: H
authors.lastname: Lukkarinen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000523:psychology / Q000534:rehabilitation; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006304:Health Status; D006801:Humans; D007383:Intermittent Claudication / Q000523:psychology / Q000534:rehabilitation; D035002:Lower Extremity; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011788:Quality of Life