Abstract 3113: Uncontrolled Hypertension, Systolic and Diastolic Blood Pressure and Development of Symptomatic Peripheral Arterial Disease in the Women’s Health Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Tiffany M Powell ◽  
Robert J Glynn ◽  
Mark A Creager ◽  
Paul M Ridker ◽  
Aruna D Pradhan
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Arterial Disease ◽  
Uncontrolled Hypertension ◽  
Health Study ◽  
Adjusted Risk ◽  
Treatment Status ◽  
Peripheral Arterial

Background : Prospective data pertaining to risk factors for peripheral arterial disease (PAD) in women are sparse. Few studies have evaluated blood pressure, including uncontrolled hypertension, and PAD onset in women. Methods and Results : We examined the relationship between blood pressure and development of confirmed symptomatic PAD (n=116 events) in a prospective cohort study of 39,261 female health professionals aged ≤ 45 years without diagnosed vascular disease at baseline. Median follow-up was 11.4 years. Women were first grouped according to baseline presence of uncontrolled hypertension, defined as reported systolic blood pressure (SBP)≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and pharmacologic treatment status. SBP and DBP were then modeled as continuous and categorical exposures irrespective of treatment status. Pulse pressure (PP) and mean arterial pressure (MAP) were also assessed. Age-adjusted and multivariable-adjusted risk estimates were derived from Cox proportional hazards models. Women with treated but uncontrolled hypertension had the highest risk of symptomatic PAD (0.67 events per 1000 person-years). Adjusted hazard ratios (HRs) compared to women without hypertension were 1.1 (95% CI, 0.5–2.3) for women who were treated and controlled, 1.7 (95% CI, 1.0 –3.0) for women untreated and uncontrolled, and 2.3 (95% CI, 1.4 – 4.0) for women treated and uncontrolled (p-trend<0.001). When hypertension was examined using continuous and categorical measures, there was a 33% increase in risk per 10 mmHg of SBP (95% CI, 18 to 47%) and a positive gradient in multivariable-adjusted risk according to SBP category (<120, 120 –139, 140 –159, and ≤ 160 mmHg); HRs were 1.0, 1.6, 2.8, and 4.3 (p-trend<0.001), respectively. We also considered DBP, PP, and MAP. While individually predictive, none was a stronger predictor than SBP with none adding predictive ability beyond SBP. Conclusions : Uncontrolled hypertension is associated with incident symptomatic PAD in women. Among blood pressure variables assessed, SBP is the best single predictor. These data support a strong prognostic role for systolic blood pressure in the development of peripheral atherosclerosis in women.

Role of systolic blood pressure and plasma triglycerides in diabetic peripheral arterial disease. The Edinburgh Artery Study

Diabetes Care ◽  
1999 ◽  
Vol 22 (3) ◽  
pp. 453-458 ◽  
Author(s):  
A. S. MacGregor ◽  
J. F. Price ◽  
C. M. Hau ◽  
A. J. Lee ◽  
M. N. Carson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Arterial Disease ◽  
Plasma Triglycerides ◽  
Peripheral Arterial

scholarly journals Hyperoxia Exaggerates Systolic Blood Pressure Response in Patients with Peripheral Arterial Disease

2021 ◽  
Vol 35 (S1) ◽  
Author(s):  
Zhaohui Gao ◽  
Jonathon Stavres ◽  
Jian Cui ◽  
Kristen Brandt ◽  
Dani Jin‐Kwang Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Blood Pressure Response ◽  
Arterial Disease ◽  
Pressure Response ◽  
Peripheral Arterial

scholarly journals Interarm Difference in Blood Pressure: Reproducibility and Association with Peripheral Vascular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jesper Mehlsen ◽  
Niels Wiinberg
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Arterial Disease ◽  
Peripheral Vascular ◽  
Vascular Laboratory ◽  
Insignificant Difference ◽  
Peripheral Arterial ◽  
The Right ◽  
Diagnosis Of Hypertension

The present study aimed at examining the interarm difference in blood pressure and its use as an indicator of peripheral arterial disease (PAD). Data were included from consecutive patients referred from their general practitioner to our vascular laboratory for possible PAD aged 50 years or older without known cardiac disease, renal disease, or diabetes mellitus. 824 patients (453 women) with mean age of 72 years (range: 50–101) were included. 491 patients had a diagnosis of hypertension and peripheral arterial disease (PAD) was present in 386 patients. Systolic blood pressure was 143 ± 24 mmHg and 142 ± 24 mmHg on the right and left arm, respectively (P=0.015). The interarm difference was greater in patients with hypertension (P=0.002) and PAD (P<0.0005). 443 patients were measured on two separate occasions and the interarm difference for systolic blood pressure was reproducible for differences >20 mmHg. This study confirmed the presence of a systematic but clinically insignificant difference in systolic blood pressure between arms. The interarm difference was larger in hypertension and PAD. Consistent lateralisation is present for differences ≥20 mmHg and an interarm difference >25 mmHg is a reliable indicator of PAD in the legs.

Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease

2021 ◽  
pp. 1-8
Author(s):  
Susan Matthews ◽  
Martin Fox ◽  
Sarah Coy ◽  
Jane Whittaker ◽  
Gail Brough ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Cardiac Rehabilitation ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Morbidity And Mortality ◽  
Supervised Exercise ◽  
Peripheral Arterial

Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

scholarly journals Heat therapy vs. supervised exercise therapy for peripheral arterial disease: a 12-wk randomized, controlled trial

2019 ◽  
Vol 316 (6) ◽  
pp. H1495-H1506 ◽  
Author(s):  
Ashley P. Akerman ◽  
Kate N. Thomas ◽  
Andre M. van Rij ◽  
E. Dianne Body ◽  
Mesfer Alfadhel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Water Immersion ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Hot Water ◽  
Walking Distance ◽  
Supervised Exercise ◽  
Heat Therapy ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is characterized by lower limb atherosclerosis impairing blood supply and causing walking-induced leg pain or claudication. Adherence to traditional exercise training programs is poor due to these symptoms despite exercise being a mainstay of conservative treatment. Heat therapy improves many cardiovascular health outcomes, so this study tested if this was a viable alternative cardiovascular therapy for PAD patients. Volunteers with PAD were randomized to 12 wk of heat ( n = 11; mean age 76 ± 8 yr, BMI 28.7 ± 3.5 kg/m2, 4 females) or exercise ( n = 11; 74 ± 10 yr, 28.5 ± 6.8 kg/m2, 3 females). Heat involved spa bathing at ∼39°C, 3–5 days/wk for ≤30 min, followed by ≤30 min of callisthenics. Exercise involved ≤90 min of supervised walking and gym-based exercise, 1–2 days/wk. Following the interventions, total walking distance during a 6-min walk test increased (from ∼350 m) by 41 m (95% CI: [13, 69], P = 0.006) regardless of group, and pain-free walking distance increased (from ∼170 m) by 43 m ([22, 63], P < 0.001). Systolic blood pressure was reduced more following heat (−7 mmHg, [−4, −10], P < 0.001) than following exercise (−3 mmHg, [0, −6], P = 0.078), and diastolic and mean arterial pressure decreased by 4 mmHg in both groups ( P = 0.002). There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were no differences in the improvement in functional or blood pressure outcomes between heat and exercise in individuals with PAD. NEW & NOTEWORTHY Heat therapy via hot-water immersion and supervised exercise both improved walking distance and resting blood pressure in peripheral arterial disease (PAD) patients over 12 wk. Adherence to heat therapy was excellent, and the heat intervention was well tolerated. The results of the current study indicate that heat therapy can improve functional ability and has potential as an effective cardiovascular conditioning tool for individuals with PAD. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/heat-therapy-vs-exercise-in-peripheral-arterial-disease/ .

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