Int J Angiol 2017; 26(03): 179-185
DOI: 10.1055/s-0037-1598177
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Discrepancies in Prevalence of Peripheral Arterial Disease between Lower Extremities at Rest and Postexercise

Kevin P. Cohoon
1   Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota
2   Department of Internal Medicine; Mayo Clinic, Rochester, Minnesota
,
Guillaume Mahe
1   Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota
3   Univ Rennes 1, University Hospital of Rennes, France and Inserm, Clinical Investigation Center (CIC) 1414, Rennes, France
,
David A. Liedl
1   Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota
2   Department of Internal Medicine; Mayo Clinic, Rochester, Minnesota
,
Thom W. Rooke
1   Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota
2   Department of Internal Medicine; Mayo Clinic, Rochester, Minnesota
,
Paul W. Wennberg
1   Department of Cardiovascular Diseases and Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota
2   Department of Internal Medicine; Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

Publication Date:
16 February 2017 (online)

Preview

Abstract

Background Lower extremity peripheral arterial disease (PAD) is a common medical condition causing substantial morbidity. Limited data exist on whether discrepancies in PAD prevalence exist between the lower extremities using resting ankle-brachial indices (ABIs) and postexercise pressures.

Objective We predicted the prevalence of PAD between the lower extremities.

Methods and Results Consecutive patients who had undergone a noninvasive arterial lower extremity study at Mayo Clinic, Rochester, MN, between January 1996 and December 2012 with suspected PAD were retrospectively reviewed. We identified 12,312 consecutive patients who underwent an arterial lower extremity and an exercise treadmill study. Prevalence of PAD was assessed at rest and after exercise using two criteria: a resting ABI ≤ 0.90 and a postexercise pressure decrease of > 30 mm Hg. Mean age was 67 ± 12 years and there were 4,780 (39%) women studied. At rest, we found a higher prevalence of PAD on the left extremity (27.4%) compared with the right (24.6%) (p < 0.0001). After exercise, we found a higher prevalence of PAD on the right extremity (25.1%) compared with the left (19.0%) (p < 0.0001). These discrepancies between the prevalence of PAD at rest and after exercise were present in women and men.

Conclusion Using validated criteria of a resting ABI of ≤ 0.90 and postexercise ankle pressure decrease > 30 mm Hg, our results suggest that there is a significantly higher prevalence of PAD in the left lower extremity at rest, in contrast to a greater prevalence of abnormal postexercise testing in the right lower extremity. The reason(s) of these discrepancies remain to be studied.

Disclosures

None.