Sedentary people are more likely to develop peripheral artery disease, study shows


New research shows that there may be a connection between low lifetime recreational activity and increased peripheral artery disease. According to John P Cooke, research co-author, up to now the relationship between low lifetime recreational activity and the risk of developing peripheral artery disease had been unknown. The study was published in the August 2011 issue of the Journal of Vascular Surgery.  

“Our study is the first to reveal that a person’s level of recreational activity is associated with whether or not they develop peripheral artery disease,” said Cooke, who is professor of medicine at Falk Cardiovascular Research Center at Stanford University Medical Center in Stanford, USA. “We studied 1,381 patients between April 2004 and January 2008 who were referred to either Stanford or Mt. Sinai Medical Center in New York City for elective coronary angiography. Our goal was to understand what environmental or genetic factors increased the risk for peripheral artery disease. In the current study, we wanted to know if a lifetime of recreational activity would protect against developing peripheral artery disease.”

Peripheral artery disease was defined as ankle-brachial index (ABI) less than 0.9 at the time of presentation or a history of revascularisation of the lower extremities regardless of ABI measure. “We used a validated physical activity questionnaire to retrospectively measure each patient’s lifetime recreational activity,” he said. “We assessed the amount of recreational activity that people had engaged in during their adult life. Our lifetime recreational activity questionnaire assessed the frequency and duration over their lifetime that each individual engaged in vigorous activity such as jogging, moderate activity such as golf, and light activity such as strolling. Statistical analyses were used to assess the independent association of lifetime recreational activity to ABI and the presence of peripheral artery disease.”

Evidence of peripheral artery disease was present in 19% (258 patients) of the patients. The least active patients had a significantly lower average ABI. A higher proportion had peripheral artery disease (25.6% compared to 13.7% of non-sedentary patients). Also, they had greater diastolic blood pressure and were more likely to be female.

In a regression model, including traditional risk factors and lifetime recreational activity, multivariate analysis showed: age, female gender, fasting glucose, cumulative years of tobacco pack use, systolic blood pressure and serum triglycerides were independent negative predictors of ABI. Patients who reported no regular lifetime recreational activity had a 1.5 increased chance of having peripheral artery disease after corrected for other cardiovascular risk factors.

“In our study, there was a group of people who engaged in absolutely no recreational exercise,” said Cooke. “These individuals were more likely to develop peripheral artery disease later in life compared with others who engaged in any recreational activity.”

“Our study adds important new information regarding the association of recreational activity and the prevalence of peripheral artery disease. Although it is well-known that patients with peripheral artery disease are sedentary, it was not known if this was a cause or an effect of peripheral artery disease. Our study indicates that people who are sedentary during their lifetime are more likely to develop peripheral artery disease. The lifetime recreational activity questionnaire may be a useful clinical screening tool for peripheral artery disease risk. Based on our study, it seems likely that people who regularly engage in recreational activity (even mild exercise such as strolling) throughout their lives are much less likely to develop lifestyle-limiting and limb threatening peripheral artery disease.”