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. 2017 Nov 1;123(5):1160-1165.
doi: 10.1152/japplphysiol.00431.2017. Epub 2017 Aug 17.

Blood pressure and leg deoxygenation are exaggerated during treadmill walking in patients with peripheral artery disease

Amanda J Miller  1 , J Carter Luck  1 , Danielle Jin-Kwang Kim  1 , Urs A Leuenberger  1 , David N Proctor  2 , Lawrence I Sinoway  1 , Matthew D Muller  3
Affiliations

Blood pressure and leg deoxygenation are exaggerated during treadmill walking in patients with peripheral artery disease

Amanda J Miller et al. J Appl Physiol (1985). .

Abstract

The purpose of this study was to investigate blood pressure (BP) and leg skeletal muscle oxygen saturation (Smo2) during treadmill walking in patients with peripheral artery disease (PAD) and healthy subjects. Eight PAD patients (66 ± 8 yr, 1 woman) and eight healthy subjects (65 ± 7 yr, 1 woman) walked on a treadmill at 2 mph (0.89 m/s). The incline increased by 2% every 2 min, from 0 to 15% or until maximal discomfort. BP was measured every 2 min with an auscultatory cuff. Heart rate (HR) was recorded continuously with an ECG. Smo2 in the gastrocnemius muscle was measured on each leg using near-infrared spectroscopy. The change in systolic BP from seated to peak walking time (PWT) was greater in PAD (healthy: 23 ± 9 vs. PAD: 44 ± 19 mmHg, P = 0.007). HR was greater in PAD patients compared with controls at PWT (P = 0.011). The reduction in Smo2 (PWT - seated) was greater in PAD (healthy: 15 ± 12 vs. PAD: 49 ± 5%, P < 0.001) in the most affected leg and in the least affected leg (healthy: 12 ± 11 vs. PAD: 32 ± 18%, P = 0.003). PAD patients have an exaggerated decline in leg Smo2 during walking compared with healthy subjects, which may elicit the exaggerated rise in BP and HR during walking in PAD.NEW & NOTEWORTHY This is the first study to simultaneously measure skeletal muscle oxygen saturation and blood pressure (BP) during treadmill exercise in patients with peripheral arterial disease. We found that BP and leg deoxygenation responses to slow-paced, graded treadmill walking are greater in patients with peripheral arterial disease compared with healthy subjects. These data may help explain the high cardiovascular risk in patients with peripheral arterial disease.

Keywords: blood pressure; near-infrared spectroscopy; peripheral artery disease; walking.

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Figures

Fig. 1.
Fig. 1.
Effects of Gardner treadmill walking test on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and skeletal muscle oxygen saturation (Smo2) in the medial gastrocnemius muscle in the most symptomatic leg of peripheral artery disease (PAD) patients (n = 8, filled circles) and healthy subjects (n = 8, open diamonds). The claudication onset time (COT) and peak walking time (PWT) time points represent the initial and maximum claudication symptoms reported by each PAD patient. Controls’ data are time matched to PAD subjects. Data are presented as means ± SD; *P < 0.05 between groups.
Fig. 2.
Fig. 2.
The change in rate pressure product (systolic blood pressure × heart rate) in patients with peripheral artery disease (PAD; closed circles) and in healthy controls (open circles).
See this image and copyright information in PMC

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