Asymptomatic peripheral arterial disease is independently associated with impaired lower extremity functioning - The Women's Health and Aging Study

Background-We report the implications of asymptomatic lower extremity perip heral arterial disease (PAD) for lower extremity functioning among particip ants in the Women's Health and Aging Study, an observational study of disab led women greater than or equal to 65 years of age living in and around Bal timore. Methods and Results-The ankle brachial index (ABI) and measures of upper an d lower extremity functioning were measured among study participants. Of 93 3 women with ABI less than or equal to 1.50, 328 (35%) had an ABI <0.90, co nsistent with PAD. Sixty-three percent of PAD participants had no exertiona l leg pain. Among participants without exertional leg pain, lower ABI level s were associated with slower walking velocity, poorer standing balance sco re, slower time to arise 5 times consecutively from a seated position, and fewer blocks walked per week, adjusting for age, sex, race, cigarette smoki ng, and comorbidities, ABI was not associated independently with measures o f upper extremity functioning. Conclusions-Asymptomatic PAD is common and is independently associated with impaired lower extremity functioning. In addition to preventing cardiovasc ular morbidity and death, further study is warranted to identify effective interventions to improve functioning among the growing number of men and wo men with asymptomatic PAD.