Peripheral arterial disease, a manifestation of systemic atherosclerosis,affects approximately 8 million to 10 million people in theUnited States, with an age-adjusted prevalence of 12 percentthat increases to 20 percent if only persons older than 70 yearsare considered.1,2 Claudication, defined as walking-inducedpain in one or both legs (primarily affecting the calves) thatdoes not go away with continued walking and is relieved onlyby rest, is present in 15 to 40 percent of patients with peripheralarterial disease3 and is associated with a diminished abilityto perform daily activities.3,4,5
Formation of Collateral Vessels and Increased Blood Flow
Changes in Microcirculation and Endothelial Function
The Hemorheologic Hypothesis
Changes in Muscle Metabolism and Oxygen Extraction
Inflammation and Muscle Injury
Walking Economy
Atherosclerosis and Prothrombotic Risk Factors
Exercise Prescription
Exercise Combined with Other Treatments
Conclusions
Source Information
From the Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore (K.J.S.); the Section of Vascular Medicine, Divisions of Cardiology (W.R.H., J.G.R.), Geriatrics (W.R.H.), and Internal Medicine (J.G.R.), Department of Medicine, University of Colorado Health Sciences Center, Denver; the Colorado Prevention Center, Denver (W.R.H.); and the Vascular Medicine Program, Cardiovascular Division, Minnesota Vascular Diseases Centers, University of Minnesota Medical School, Minneapolis (A.T.H.).
Address reprint requests to Dr. Stewart at Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, MD 21224, or at kstewart@mail.jhmi.edu.
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