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Relationship between walking capacity and ambulatory blood pressure in patients with intermittent claudication

Lima, Aluísio H.R.A.a; Chehuen, Marcela; Cucato, Gabriel G.b; Soares, Antônio H. G.c; Askew, Christopher D.d; Barbosa, João P.A.S.a; Gomes, Crivaldo C. Jre; Wolosker, Nelsonb; Forjaz, Claudia L.M.a; Ritti-Dias, Raphael M.b

doi: 10.1097/MBP.0000000000000243
Clinical Methods and Pathophysiology

Objective Patients with intermittent claudication (IC) often have high blood pressure (BP), which increases their cardiovascular risk. However, whether walking capacity is associated with BP levels in patients with IC remains unknown. Therefore, this study was designed to investigate whether the total walking distance is associated with ambulatory BP in patients with IC.

Participants and methods This was a cross-sectional study of 75 patients with IC (58 men; 17 women). A maximal treadmill test (Gardner protocol) was performed to assess total walking distance in these patients. Furthermore, ambulatory BP, heart rate, rate–pressure product, and BP load were obtained over a 24-h period. One-way analysis of variance and multiple linear regression were carried out.

Results Walking capacity was correlated negatively with the following: (i) asleep systolic BP, diastolic BP, mean BP and heart rate; (ii) 24-h, awake and asleep RPP; and (iii) awake and asleep systolic BP load (all P<0.05). These associations occurred irrespective of confounders such as age, sex, BMI, smoking status, and number of antihypertensive medications.

Conclusion A better walking capacity is associated with lower ambulatory BP parameters in patients with IC.

aExercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo

bAlbert Einstein Israelite Hospital, São Paulo

cSchool of Physical Education, University of Pernambuco, Pernambuco

dCenter of Physical Education and Sport, State University of Londrina, Londrina, Brazil

eSchool of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia

Correspondence to Aluísio H.R.A. Lima, MD, School of Physical Education and Sport, University of São Paulo, Av. Professor Melo Moraes, 65, 05508-030 São Paulo, Brazil Tel: +55 119 5847 1567; fax: +55 11 3813 5921; e-mail:

Received April 7, 2016

Received in revised form December 20, 2016

Accepted January 23, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.