The Key We Are Overlooking in Peripheral Vascular Disease

To change the prognosis of peripheral vascular disease patients, a referral for supervised exercise is paramount. This should be a cultural change, not only an individual recommendation.

A physically active lifestyle reduces the risk of cardiovascular events and functional impairment in patients with peripheral vascular disease.

The novelty of this work (forthcoming in Eur J Vasc Endovasc Surg) is that it compares physical activity patterns from peripheral vascular disease patients in two countries: one presenting an epidemic of sedentary and overweight individuals (United Stated) and another that actively promotes physical activity as a public health policy (the Netherlands).

Patients self-reported their physical activity following a binary classification (sedentarism or physical activity), with follow-up at 3, 6, and 12 months.

Participants were registered in the Patient-centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry, which included patients with new or worsening intermittent claudication.

This study included a total of 1098 patients: 743 recruited in the US (67.7%) and 355 in the Netherlands (32.3%).

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American patients were older (mean age: 68.6 years vs. 65.3 years; p < 0.001) and heavier (41.3% vs. 20.5%; p < 0.001), but fewer were smokers (30.1% vs. 52.8%; p < 0.001) and more were female (41.3% vs. 31.4%; p = 0.002).

The main difference between countries was the patients’ supervised exercise baseline (1.6% in the US vs. 63.9% in the Netherlands; p < 0.001). Not only were Americans more sedentary at baseline, but also only a small percentage of them were formally instructed to exercise in a supervised manner.

Conclusion

To change the prognosis of symptomatic peripheral vascular disease patients, a referral for supervised exercise is paramount. Advising them to “walk more” is not enough: a cultural change must take place.

Original Title: Physical Activity in Patients with Symptomatic Peripheral Artery Disease: Insights from the PORTRAIT Registry.

Reference: Poghni A. Peri-Okonny et al. Eur J Vasc Endovasc Surg. 2020 Jul 21;S1078-5884(20)30528-1. https://doi.org/10.1016/j.ejvs.2020.06.010.

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