We determined the association between daily ambulatory activity and markers of inflammation and oxidative stress in patients with peripheral artery disease (PAD) and claudication. Patients with PAD (n = 134) limited by claudication were studied. Patients took 3275 ± 1743 daily strides for 273 ± 112 minutes each day, and their average daily cadence was 11.7 ± 2.7 strides/min. High-sensitivity C-reactive protein was significantly and negatively associated with the total number of daily strides (P < .001), total daily ambulatory time (P < .01), peak activity index (P < .01), daily average cadence (P < .05), and the maximum cadences for 60 minutes (P < .05), 30 minutes (P < .05), 20 minutes (P < .05), and 5 minutes (P < .01). Oxidized low-density lipoprotein and soluble vascular cell adhesion molecule 1 were not significantly associated with any of the ambulatory measures (P > .05). We conclude that higher levels of community-based, daily ambulatory activity are associated with lower levels of inflammation but are not associated with markers of oxidative stress.
HirschATHaskalZJHertzerNR. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006;113(11):e463–e654.
2.
NorgrenLHiattWRDormandyJANehlerMRHarrisKAFowkesFG. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45(suppl S):S5–S67.
3.
BrassEPHiattWR. Review of mortality and cardiovascular event rates in patients enrolled in clinical trials for claudication therapies. Vasc Med. 2006;11(3):141–145.
4.
CriquiMHLangerRDFronekA. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992;326(6):381–386.
5.
GardnerAWSkinnerJSCantwellBWSmithLK. Progressive vs single-stage treadmill tests for evaluation of claudication. Med Sci Sports Exerc. 1991;23(4):402–408.
6.
HiattWRNawazDRegensteinerJGHossackKF. The evaluation of exercise performance in patients with peripheral vascular disease. J Cardiopulmonary Rehabil. 1988;8(12):525–532.
7.
McDermottMMGreenlandPLiuK. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001;286(13):1599–1606.
8.
McDermottMMLiuKGreenlandP. Functional decline in peripheral arterial disease: associations with the ankle brachial index and leg symptoms. JAMA. 2004;292(4):453–461.
9.
McDermottMMLiuKO'BrienE. Measuring physical activity in peripheral arterial disease: a comparison of two physical activity questionnaires with an accelerometer. Angiology. 2000;51(2):91–100.
10.
SieminskiDJGardnerAW. The relationship between free-living daily physical activity and the severity of peripheral arterial occlusive disease. Vasc Med. 1997;2(4):286–291.
11.
GardnerAWPoehlmanET. Exercise rehabilitation programs for the treatment of claudication pain. A meta-analysis. JAMA. 1995;274(12):975–980.
12.
HickmanPHarrisonDKHillA. Exercise in patients with intermittent claudication results in the generation of oxygen derived free radicals and endothelial damage. Adv Exp Med Biol. 1994;361:565–570.
13.
KhairaHSMaxwellSRShearmanCP. Antioxidant consumption during exercise in intermittent claudication. Br J Surg. 1995;82(12):1660–1662.
14.
SilvestroAScopacasaFOlivaGde CristofaroTIulianoLBrevettiG. Vitamin C prevents endothelial dysfunction induced by acute exercise in patients with intermittent claudication. Atherosclerosis. 2002;165(2):277–283.
15.
TurtonEPCoughlinPAKesterRCScottDJ. Exercise training reduces the acute inflammatory response associated with claudication. Eur J Vasc Endovasc Surg. 2002;23(4):309–316.
16.
PipinosIIJudgeARSelsbyJT. The myopathy of peripheral arterial occlusive disease: part 1. Functional and histomorphological changes and evidence for mitochondrial dysfunction. Vasc Endovascular Surg. 2007;41(6):481–489.
17.
PipinosIIJudgeARSelsbyJT. The myopathy of peripheral arterial occlusive disease: Part 2. Oxidative stress, neuropathy, and shift in muscle fiber type. Vasc Endovascular Surg. 2008;42(2):101–112.
18.
GardnerAWParkerDEMontgomeryPSScottKJBlevinsSM. Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: a randomized controlled trial. Circulation. 2011;123(5):491–498.
HiattWRMarshallJABaxterJ. Diagnostic methods for peripheral arterial disease in the San Luis Valley Diabetes Study. J Clin Epidemiol. 1990;43(6):597–606.
21.
TorresJLRidkerPM. High sensitivity C-reactive protein in clinical practice. Am Heart Hosp J. 2003;1(3):207–211.
22.
GardnerAW. Reliability of transcutaneous oximeter electrode heating power during exercise in patients with intermittent claudication. Angiology. 1997;48(3):229–235.
23.
FeinbergRLGregoryRTWheelerJR. The ischemic window: a method for the objective quantitation of the training effect in exercise therapy for intermittent claudication. J Vasc Surg. 1992;16(2):244–250.
24.
GardnerAWMontgomeryPSScottKJAfaqABlevinsSM. Patterns of ambulatory activity in subjects with and without intermittent claudication. J Vasc Surg. 2007;46(6):1208–1214.
25.
FordES. Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology. 2002;13(5):561–568.
26.
LavieCJChurchTSMilaniRVEarnestCP. Impact of physical activity, cardiorespiratory fitness, and exercise training on markers of inflammation. J Cardiopulm Rehabil Prev. 2011;31(3):137–145.
27.
AguilarEMMiralles JdeHGonzalezAFCasariegoCVMorenoSBGarciaFA.In vivo confirmation of the role of statins in reducing nitric oxide and C-reactive protein levels in peripheral arterial disease. Eur J Vasc Endovasc Surg. 2009;37(4):443–447.
28.
McDermottMMGuralnikJMGreenlandP. Statin use and leg functioning in patients with and without lower-extremity peripheral arterial disease. Circulation. 2003;107(5):757–761.
29.
MohlerER3rdHiattWRCreagerMA. Cholesterol reduction with atorvastatin improves walking distance in patients with peripheral arterial disease. Circulation. 2003;108(12):1481–1486.
