title: Low lifetime recreational activity is a risk factor for peripheral arterial disease.
abstract: BACKGROUND
  The relationship between lifetime physical activity and the risk of developing peripheral arterial disease (PAD) is not known.
  
  
  METHODS
  We studied 1381 patients referred for elective coronary angiography in a point prevalence analysis. PAD was defined as ankle-brachial index (ABI) <0.9 at the time or a history of revascularization of the lower extremities regardless of ABI measure. We used a validated physical activity questionnaire to retrospectively measure each patient's lifetime recreational activity (LRA). Multivariate and logistic regression analyses were used to assess the independent association of LRA to ABI and the presence of PAD.
  
  
  RESULTS
  PAD was present in 19% (n = 258) of all subjects. Subjects reporting no regular LRA had greater diastolic blood pressure and were more likely to be female. They had lower average ABI, and a higher proportion had PAD (25.6%). In a regression model, including traditional risk factors and LRA, multivariate analysis showed that age (P < .001), female gender (P < .001), systolic blood pressure (P = .014), fasting glucose (P < .001), serum triglycerides (P = .02), and cumulative pack years (P < .001) were independent negative predictors of ABI, and LRA was a positive predictor of ABI (P < .001). History of sedentary lifestyle independently increased the odds ratio for PAD (odds ratio, 0.46; 95% confidence interval, 1.01-2.10) when assessed by logistic regression. Intriguingly, there is a correlation between physical activity and gender, such that women with low LRA are at greatest risk.
  
  
  CONCLUSIONS
  Recalled LRA is positively correlated to ABI and associated with PAD. Whereas the mechanism for this effect is not clear, LRA may be a useful clinical screening tool for PAD risk, and strategies to increase adult recreational activity may reduce the burden of PAD later in life.
authors.affiliation: Department of Medicine, University of Melbourne, Melbourne, Australia.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Wilson
authors.forename: Amir H
authors.initials: AH
authors.lastname: Sadrzadeh-Rafie
authors.forename: Jonathan
authors.initials: J
authors.lastname: Myers
authors.forename: Themistocles
authors.initials: T
authors.lastname: Assimes
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Nead
authors.forename: Mamie
authors.initials: M
authors.lastname: Higgins
authors.forename: Andre
authors.initials: A
authors.lastname: Gabriel
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Olin
authors.forename: John P
authors.initials: JP
authors.lastname: Cooke
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D015995:Prevalence; D011998:Recreation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D057185:Sedentary Behavior; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D014481:United States; D014656:Vascular Surgical Procedures
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D014280:Triglycerides