Abstract 3076: Low Lifetime Recreational Activity is a Risk Factor for Peripheral Arterial Disease
BACKGROUND: Although it is known that individuals with peripheral arterial disease (PAD) are sedentary, the relationship between lifetime physical activity and the risk of developing PAD is not known.
METHODS: We studied 1381 patients (mean age ± [SD], 65 ± 11) referred for elective coronary angiography at Stanford and Mt Sinai Medical Centers from 2004 to 2008. PAD was defined as ankle-brachial index (ABI) < 0.9 at the time of their angiograms or a history of arterial bypass of the lower extremities regardless of ABI measure. We used a validated physical activity questionnaire to retrospectively measure each patient’s lifetime recreational activity (LRA). Multivariate and logistic regression analyses were used to assess the independent association of LRA to ABI and the presence of PAD.
RESULTS: PAD was present in 19% of subjects. Subjects reporting no regular LRA had greater levels of diastolic BP and were more likely to be female. They had lower average ABI, and a higher proportion had PAD (26%). In a regression model including traditional risk factors and LRA, multivariate analysis showed that age (p <0.001), female gender (p <0.001), systolic blood pressure (p=0.014), fasting glucose (p <0.001), serum triglycerides (p =0.02) and cumulative pack years (p <0.001) were independent negative predictors of ABI, and LRA was a positive predictor of ABI (p <0.001). History of sedentary lifestyle was an independent risk factor for PAD (OR =1.46; 95% CI, 1.011–2.103) when assessed by logistic regression. Intriguingly, there is an interaction between physical activity and gender, such that women with low LRA are at greatest risk.
CONCLUSIONS: Recalled LRA is positively correlated to ABI and low LRA is an independent risk factor for PAD. Whereas the mechanism for this effect is not clear, strategies to increase adult recreational activity may reduce the burden of PAD later in life.