Effects of exercise rehabilitation on endothelial reactivity in older patients with peripheral arterial disease

Peripheral arterial disease (PAD) is a major cause of morbidity and mortali ty, Endothelial function, which is a measure of vascular health, is impaire d in patients with PAD. We examined the effects of 6 months of aerobic exer cise rehabilitation on brachial artery endothelial function, assessed using high-frequency ultrasonography, and calf blood flow in 19 older PAD patien ts (age 69 +/- 1 years, mean +/- SEM) with intermittent claudication (ankle to brachial artery index of 0.73 +/- 0.04), After exercise, the time to on set of claudicatian pain increased by 94%, from 271 +/- 49 to 525 +/- 80 se conds (p <0.01), and the time to maximal claudicatian pain increased by 43% , from 623 +/- 77 to 889 +/- 75 seconds (p <0.05). Exercise rehabilitation increased the flow-mediated brachial arterial diameter by 61%, from 0.18 +/ - 0.03 to 0.29 +/- 0.04 mm (p <0.005), as well as the relative change in br achial arterial diameter from the resting state by 60%, from 4.81 +/- 0.82% to 7.97 +/- 1.03% (p < 0.005), Maximal calf blood flow (14.2 +/- 1.0 vs 19 .2 +/- 2.0 ml/100 ml/min; p = 0.04), and postocclusive reactive hyperemic b lood flow (9.8 +/- 0.8 vs 11.3 +/- 0.7 ml/100 ml/min; p = 0.1) increased 35 % and 15%, respectively. In conclusion, exercise rehabilitation improved am bulatory function, endothelial-dependent dilation, and calf blood flow in o lder PAD patients with intermittent claudication. (C) 2001 by Excerpta Medi co, Inc.