title: Obesity decreases time to claudication and delays post-exercise hemodynamic recovery in elderly peripheral arterial disease patients.
abstract: 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.
authors.affiliation: Nutrition Department, Faculty of Public Health, University of São Paulo, São Paulo, Brazil. rdias@usp.br
authors.forename: Raphael Mendes Ritti
authors.initials: RM
authors.lastname: Dias
authors.forename: Cláudia Lúcia de Moraes
authors.initials: CL
authors.lastname: Forjaz
authors.forename: Gabriel Grizzo
authors.initials: GG
authors.lastname: Cucato
authors.forename: Luis Augusto Riani
authors.initials: LA
authors.lastname: Costa
authors.forename: Lucas Caseri
authors.initials: LC
authors.lastname: Câmara
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: Maria de Fátima Nunes
authors.initials: Mde F
authors.lastname: Marucci
mesh_terms: 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*