Association Between Physical Activity and Mortality in Patients With Claudication

Andrew W. Gardner; Odessa Addison; Leslie I. Katzel; Polly S. Montgomery; Steven J. Prior; Monica C. Serra; John D. Sorkin

Disclosures

Med Sci Sports Exerc. 2021;53(4):732-739. 

In This Article

Results

The demographic and clinical characteristics of patients with claudication according to baseline physical activity status are shown in Table 1. At baseline, the groups were significantly different on age (P = 0.01), sex (P = 0.005), obesity (P = 0.02), history of cerebrovascular accidents (P = 0.02), and years of survival from baseline enrollment (P < 0.001) (Table 1). The median survival time for the entire sample was 9.9 yr (interquartile range, 4.9 to 15.7 yr; range, 0.38 to 18.7 yr). Compared with individuals in the sedentary group, those in the light-intensity physical activity group and the moderate- to vigorous-intensity physical activity group on average lived 5 yr more (mean age of death 79 vs 74 yr).

Of the 386 patients, 257 (66.6%) died during the follow-up period, consisting of 40/48 (83.3%) from the sedentary group, 135/210 (64.3%) from the light-intensity physical activity group, and 82/128 (64.0%) from the moderate- to vigorous-intensity physical activity group. The adjusted fraction of men who were alive was lower than the fraction of women at each time point. In both men and women survival followed activity level (Figure 1). Survival was lowest in the sedentary group (act 0), intermediate in the light-intensity physical activity group (act 1), and highest in the moderate- to vigorous-intensity activity group (act 2). Significant predictors of all-cause mortality included light-intensity physical activity status (P = 0.001), moderate- to vigorous-intensity physical activity status (P < 0.001), age at baseline (P < 0.001), male sex (P < 0.001), ABI (P = 0.006), smoking pack-years (P = 0.022), and diabetes (P = 0.004) (Table 2).

Figure 1.

Adjusted survival curves, by sex, based on mortality from all-causes among patients with PAD and claudication, grouped according to their baseline physical activity status of sedentary (act 0), light-intensity physical activity (act 1), and moderate- to vigorous-intensity physical activity (act 2). The figure was produced for a male (M) and female (F) 68 yr old, with a BMI of 28.0 kg·m−2, an ABI of 0.67, a 39.9 pack-year smoking history, without hypertension, diabetes, hyperlipidemia, stroke, or lower extremity revascularization.

Of the 257 decedents, 125 (48.6%) died due to cardiovascular causes. For cardiovascular mortality, the adjusted fraction of men and women alive was not statistically different at any time point (Figure 2 and Table 3). Survival was lowest in the sedentary group (act 0), intermediate in the light-intensity physical activity group (act 1), and highest in the moderate- to vigorous-intensity physical activity group (act 2). Significant predictors of cardiovascular mortality included light-intensity physical activity status (P = 0.011), moderate- to vigorous-intensity physical activity status (P < 0.001), age at baseline (P = 0.006), and ABI (P = 0.001).

Figure 2.

Adjusted survival curves, by sex, based on mortality from cardiovascular causes among patients with PAD and claudication, grouped according to their baseline physical activity status of sedentary (act 0), light-intensity physical activity (act 1), and moderate- to vigorous-intensity physical activity (act 2). The figure was produced for a male (M) and female (F) 68 yr old, with a BMI of 28.0 kg·m−2, and ABI of 0.67, a 39.9 pack-year smoking history, without hypertension, diabetes, hyperlipidemia, stroke, or lower extremity revascularization.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....