Obesity decreases time to claudication and delays post-exercise hemodynamic recovery in elderly peripheral arterial disease patients.
BACKGROUND
Althoughobesity is usually observed in peripheral arterial disease (PAD) patients, the effects of the association between these diseases on walking capacity are not well documented.


OBJECTIVE
The main objectives of this study were to determine the effects of obesity on exercise tolerance and post-exercise hemodynamic recovery in elderly PAD patients.


METHODS
46 patients with stable symptoms of intermittent claudication were classified according to their body mass index (BMI) into normal group (NOR) = BMI <28.0 and obese or in risk of obesity group (OBE) = BMI >or=28.0. All patients performed a progressive graded treadmill test. During exercise, ventilatory responses were evaluated and pre- and post-exercise ankle and arm blood pressures were measured.


RESULTS
Exercise tolerance and oxygen consumption at total walking time were similar between OBE and NOR. However, OBE showed a lower claudication time (309 +/- 151 vs. 459 +/- 272 s, p = 0.02) with a similar oxygen consumption at this time. In addition, OBE presented a longer time for ankle brachial index recovery after exercise (7.8 +/- 2.8 vs. 6.3 +/- 2.6 min, p = 0.02).


CONCLUSIONS
Obesity in elderly PAD patients decreased time to claudication, and delayed post-exercise hemodynamic recovery. These results suggest that muscle metabolic demand, and not total workload, is responsible for the start of the claudication and maximal exercise tolerance in PAD patients. Moreover, claudication duration might be responsible for the time needed to a complete hemodynamic recovery after exercise.
Dias
Raphael Mendes Ritti
RM
Nutrition Department, Faculty of Public Health, University of São Paulo, São Paulo, Brazil. rdias@usp.br
Forjaz
Cláudia Lúcia de Moraes
CL
Cucato
Gabriel Grizzo
GG
Costa
Luis Augusto Riani
LA
Câmara
Lucas Caseri
LC
Wolosker
Nelson
N
Marucci
Maria de Fátima Nunes
Mde F
D000368:Aged; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D010101:Oxygen Consumption; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000503:physiopathology*