0
Sign In  | Subscribe
18 June 2002, Vol 136, No. 12>
Summaries for Patients | 18 June 2002

Associations between Peripheral Arterial Disease and Leg Function FREE

[+] Article and Author Information

The summary below is from the full report titled “The Ankle Brachial Index Is Associated with Leg Function and Physical Activity: The Walking and Leg Circulation Study.” It is in the 18 June 2002 issue of Annals of Internal Medicine (volume 136, pages 873-883). The authors are MM McDermott, P Greenland, K Liu, JM Guralnik, L Celic, MH Criqui, C Chan, GJ Martin, J Schneider, WH Pearce, LM Taylor, and E Clark.


Ann Intern Med. 2002;136(12):I-32. doi:10.7326/0003-4819-136-12-200206180-00003
Text Size: A A A

What is the problem and what is known about it so far?

The blood vessels that carry blood from the heart to the legs are called peripheral arteries. Sometimes, fatty buildup in the artery walls reduces or blocks blood flow through these arteries, a condition called peripheral arterial disease (PAD). Slightly more than 10% of Americans older than 65 years of age have PAD. The condition is more common in people who smoke or have high cholesterol levels or diabetes mellitus. Peripheral arterial disease reduces blood supply to tissues. It can cause pain in one or both calves that is present during walking and is relieved by rest (intermittent claudication). Some people with PAD do not have symptoms or leg pain. Many experience changes in leg function that affect their ability to walk.

A way to detect PAD is to get an ankle brachial index (ABI), which compares blood pressure in the arm and lower leg; PAD is diagnosed if the blood pressure in the lower leg is lower than in the arm (ABI < 0.90). Because ABI is a simple, noninvasive way to identify PAD, it allows us to study large numbers of people and to better define the types of symptoms and dysfunction associated with PAD.

Why did the researchers do this particular study?

To describe symptoms and leg function in people with PAD.

Who was studied?

740 adults (460 with and 280 without PAD) from three academic medical centers in the Chicago, Illinois, area.

How was the study done?

All patients answered questions about leg symptoms and had ABI tests to detect the presence or absence of PAD. Then, they underwent several tests that measured leg function, including a 6-minute walk test, repeated chair stands, a standing balance test, and a test of walking speed. At the time the leg function tests were performed, the patient and the researchers who gave the tests did not know the results of the patient's ABI.

What did the researchers find?

Of 460 people with PAD (ABI < 0.90), only 152 (33%) had symptoms of intermittent claudication. Compared with people who had normal ABIs, those with abnormal ABIs had worse lower-extremity function, including slower velocity, an inability to maintain a tandem stand, an inability to walk continuously, and coverage of a shorter distance during a 6-minute walk.

What were the limitations of the study?

The ABI is not 100% accurate in detecting PAD. Moreover, most of the participants with PAD were recruited from special laboratories where patients are referred specifically because PAD is suspected. People with unrecognized PAD may have different findings than people who are specifically referred for diagnostic evaluation of PAD.

What are the implications of the study?

Peripheral arterial disease is associated with impaired lower-extremity function, and many patients with PAD do not have symptoms of intermittent claudication.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

In the Clinic
Peripheral Arterial Disease
Ann Intern Med. 2007;146(5):ITC3-1.
Topic Collections
PubMed Articles
Endovascular Stents: A Review of Their Use in Peripheral Arterial Disease.
American journal of cardiovascular drugs : drugs, devices, and other interventions Issue date: 2013 Apr 12
May-Thurner syndrome in a 68-year-old woman after remote abdominal surgery.
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital Issue date: 2013

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)