In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 138, No. Suppl_1 ( 2018-11-06)
Abstract:
Background: Overweight or obese adults with PAD have greater functional decline than normal-weight adults with PAD. Walking exercise is first-line therapy for PAD. It is unknown whether weight loss+exercise is associated with less functional decline than exercise alone. Weight loss could worsen functional decline by decreasing muscle mass. Methods: Adults with PAD (ABI 〈 0.90) and BMI ≥25 kg/m 2 underwent baseline testing 2002-2004. Mean follow-up was 3.4 years. Weight, six minute walk distance (6MWD) and self-reported exercise were measured annually. Weight loss was defined as ≥5 lb decrease compared to the prior year. Exercise was defined as walking ≥3 times/week for ≥30 min. To compare annual changes in 6MWD between groups (no exercise, exercise only, or exercise+weight loss) a mixed-effects linear regression analysis was used with a subject-specific random intercept, to account for the chance that a person’s annual change in 6MWD correlated with the prior annual change. Person-years for each group were summed from successive annual changes; adults could contribute person-years to ≥1 group. Analyses were adjusted for age, race, sex, ABI, smoking, comorbidities, lower extremity revascularization or hip/knee replacement during follow-up. Results: Among 271 adults (41% women, 15% black), mean age was 74±7.6 and ABI was 0.64±0.15. Mean baseline BMI was similar across groups (no exercise 30.7±4.6 kg/m 2 ; exercise only 28.8±3.5 kg/m 2 ; exercise+weight loss 30.1±4.3 kg/m 2 ). PAD participants who walked for exercise and lost weight had less decline in 6MWD than those who walked without weight loss, or who neither exercised nor lost weight (p trend = 0.004) (Table). Conclusions: Overweight and obese adults with PAD who exercised and lost ≥5 lbs experienced less annual decline in the 6MWD than adults with only exercise or no exercise. A randomized trial is needed to determine whether weight loss+exercise improves functional outcomes for overweight or obese adults with PAD.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.138.suppl_1.17020
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2018
detail.hit.zdb_id:
1466401-X
