Journal
JOURNAL OF VASCULAR SURGERY
Volume 47, Issue 1, Pages 117-122Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jvs.2007.09.033
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Funding
- NCRR NIH HHS [M01 RR 14467, M01 RR014467, M01 RR014467-03] Funding Source: Medline
- NIA NIH HHS [R01 AG016685, P60 AG012583-05, R01 AG 16685, P60 AG012583, R01 AG016685-01A1, K01 AG000657-05, P60 AG 12583] Funding Source: Medline
- PHS HHS [K01 00657] Funding Source: Medline
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR014467] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [P60AG012583, K01AG000657, R01AG016685] Funding Source: NIH RePORTER
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Objective: We examined whether all-cause mortality was predicted by physical activity level in peripheral arterial disease (PAD) patients limited by intermittent claudication. Methods: This retrospective, natural history follow-up study determined survival status of each patient. Patients with stable symptoms of intermittent claudication were evaluated in the Geriatrics, Research, Education, and Clinical Center at the Maryland Veterans Affairs Health Care System (MVAHCS) at Baltimore between 1994 and 2002, and were classified into a physically sedentary group (n = 299) or a physically active group (n = 13 5), and followed in 2004 using the Social Security Death Index. Results: Median follow-up was 5.33 years (range = 0.25 to 8.33 years) for the physically active group, and 5.0 years (range = 0.17 to 8.5 years) for the sedentary group. At follow-up, 108 patients (24.9%) had died, consisting of 86 (28.8%) in the sedentary group and 22 (16.3%) in the active group. Unadjusted risk of mortality was lower (P = .005) in the physically active group (hazard ratio [HR] = 0.510, 95% CI = 0.319 to 0.816). In multivariate Cox proportional hazards analysis, age (HR = 1.045,95% CI = 1.019 to 1.072, P < 0.001), body mass index (BMI) (HR = 0.943,95% CI = 0.902 to 0.986, P = 0.009), ankle-brachial index (ABI) (HR = 0.202, 95% CI = 0.064 to 0.632, P = 0.006), and physical activity status (HR = 0.595, 95% CI = 0.370 to 0.955, P = .031) were predictors of mortality. Conclusion: Patients limited by intermittent claudication who engage in any amount of weekly physical activity beyond light intensity at baseline have a lower mortality rate than their sedentary counterparts who perform either no physical activity or only light-intensity activities. The protective effect of physical activity persists even after adjusting for other predictors of mortality, which include age, ABI, and BMI.
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