Effects of clustered comorbid conditions on walking capacity in patients with peripheral artery disease.
BACKGROUND
Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PAD patients. Therefore, the aim of this study was to analyze the influence of clustered comorbid conditions on walking capacity in PAD patients.


METHODS
This cross-sectional study included 415 PAD patients (155 women and 260 men with an average age of 63 years). Claudication distance and total walking distance were assessed with the graded maximal treadmill test. Medical histories of hypertension, diabetes, cerebrovascular disease (CVD), coronary artery disease (CAD), and chronic obstructive pulmonary disease (COPD) were obtained. Binary logistic regression was carried out to analyze whether clustered comorbid conditions were associated with walking capacity.


RESULTS
CVD was associated with lower total walking distance (odds ratio [OR] = 2.45; 95% confidence interval [CI]: 1.11-5.39). The cluster hypertension, diabetes, CVD, CAD, and COPD were associated with a lower claudication distance (OR = 7.63; 95% CI: 1.42-40.96). In addition, the clusters of CVD and hypertension (OR = 3.16; 95% CI: 1.38-7.23), CVD and CAD (OR = 3.46; 95% CI: 1.25-9.57), CVD, hypertension, and diabetes (OR = 11.38; 95% CI: 2.27-57.00) were associated with a lower total walking distance.


CONCLUSIONS
CVD was associated with walking impairment of IC patients and in particular when CVD is clustered with other comorbid conditions.
University of Pernambuco, Associate Graduate Program in Physical Education UPE/UFPB, Recife/PE, Brazil.
Breno Quintella
BQ
Farah
University of Pernambuco, Associate Graduate Program in Physical Education UPE/UFPB, Recife/PE, Brazil. Electronic address: raphaelritti@gmail.com.
Raphael Mendes
RM
Ritti-Dias
University of São Paulo, School of Physical Education and Sport, Exercise Hemodynamic Laboratory, São Paulo/SP, Brazil.
Gabriel Grizzo
GG
Cucato
University of São Paulo, School of Physical Education and Sport, Exercise Hemodynamic Laboratory, São Paulo/SP, Brazil.
Marcel da Rocha
Mda R
Chehuen
University of São Paulo, School of Physical Education and Sport, Exercise Hemodynamic Laboratory, São Paulo/SP, Brazil.
João Paulo dos Anjos Souza
JP
Barbosa
University of São Paulo, Faculty of Medicine, São Paulo/SP, Brazil.
Antonio Eduardo
AE
Zeratti
University of São Paulo, Faculty of Medicine, São Paulo/SP, Brazil.
Nelson
N
Wolosker
University of São Paulo, Faculty of Medicine, São Paulo/SP, Brazil.
Pedro
P
Puech-Leao
D000368:Aged; D001938:Brazil / Q000453:epidemiology; D016000:Cluster Analysis; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D016138:Walking