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(Circulation. 2000;101:1007.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Asymptomatic Peripheral Arterial Disease Is Independently Associated With Impaired Lower Extremity Functioning
The Women’s Health and Aging Study
From Northwestern University Medical School (M.M.M.), Chicago, Ill; Johns Hopkins University Medical School (L.F., S.L.), Baltimore, Md; and the Epidemiology, Biometry, and Demography Program at the National Institute on Aging (E.S., J.M.G.), Bethesda, Md.
Correspondence to Dr McDermott, 675 N St Clair, Suite 18-200, Chicago, IL 60611. E-mail MDM608{at}nwu.edu
Background—We report the
implications of asymptomatic lower extremity
peripheral arterial disease (PAD) for lower
extremity functioning among participants in the Women’s Health and
Aging Study, an observational study of disabled women 
65 years of age
living in and around Baltimore.
Methods and Results—The ankle brachial index (ABI) and measures
of upper and lower extremity functioning were measured among study
participants. Of 933 women with ABI 
1.50, 328 (35%) had an ABI
<0.90, consistent with PAD. Sixty-three percent of PAD
participants had no exertional leg pain. Among participants without
exertional leg pain, lower ABI levels were associated with slower
walking velocity, poorer standing balance score, slower time to arise 5
times consecutively from a seated position, and fewer blocks walked per
week, adjusting for age, sex, race, cigarette smoking, and
comorbidities. ABI was not associated independently with measures of
upper extremity functioning.
Conclusions—Asymptomatic PAD is common and is independently associated with impaired lower extremity functioning. In addition to preventing cardiovascular morbidity and death, further study is warranted to identify effective interventions to improve functioning among the growing number of men and women with asymptomatic PAD.
Key Words: arteries • aging • peripheral vascular disease
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