Obesity Decreases Time to Claudication and Delays Post-Exercise Hemodynamic Recovery in Elderly Peripheral Arterial Disease Patients

• Published in: Gerontology (Basel) Vol. 55; no. 1; pp. 21 - 26
• Main Authors: Ritti Dias, Raphael Mendes, Forjaz, Cláudia Lúcia de Moraes, Cucato, Gabriel Grizzo, Costa, Luis Augusto Riani, Câmara, Lucas Caseri, Wolosker, Nelson, Marucci, Maria de Fátima Nunes
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2009; S. Karger AG
• Subjects: Aged; Biological and medical sciences; Development. Metamorphosis. Moult. Ageing; Exercise; Exercise Test; Female; Fundamental and applied biological sciences. Psychology; Hemodynamics; Humans; Intermittent Claudication - etiology; Intermittent Claudication - physiopathology; Male; Middle Aged; Obesity; Obesity - complications; Obesity - physiopathology; Older people; Oxygen Consumption; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - physiopathology; Short Communication; Vein & artery diseases; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Exercise tolerance; Pain; Ankle brachial index; Intermittent claudication; Human; Physical exercise; Obesity; Senescence; Nutrition disorder; Tolerance; Cardiovascular disease; Intermittent claudication . Exercise tolerance; Arterial disease; Vascular disease; Ankle; Vertebrata; Mammalia; Occlusive arterial disease; Hemodynamics; Elderly; Nutritional status
• ISSN: 0304-324X; 1423-0003
• DOI: 10.1159/000155219

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 ≥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). Conclusion: 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.