Effects of Lifestyle Physical Activity on Vascular Function in Asymptomatic Peripheral Arterial Disease

Purpose The purpose of this study was to examine the effects of a 12-wk in-home self-monitored physical activity (PA) program targeting a combination of lifestyle PA program on changes in endothelial reactivity, arterial stiffness, sedentary behaviors, and upright and stepping activities in individuals with asymptomatic peripheral arterial disease (APAD). Methods Participants (n = 38) with APAD (ages 52-87 yr) were randomized to attention control (AC) or a PA sedentary reduction (PASR) group using an interactive online 3-month program focusing on increasing lifestyle PA and decreasing sedentary behaviors. The ActivPal (TM) PA monitor was used to measure postural and stepping parameters. Endothelial reactivity (peripheral arterial tone-reactive hyperemia index [PAT-RHI]) and augmentation index (AIx) were measured using the EndoPAT (TM) system at baseline and 3 months. Results The PASR group significantly decreased daily sit/lie hours (-0.80 +/- 0.87 vs 0.18 +/- 0.77 P = 0.001), increased sit-to-stand transitions per day (7.1 +/- 10.5 vs -1.4 +/- 5.71, P < 0.001), and increased daily step counts (2814 +/- 1753 vs 742 +/- 1321, P < 0.001). The PASR group also increased steps per day accumulated within specific cadence bands 61-80 steps per minute (1252 +/- 447 vs 177 +/- 359, P < 0.001), 81-100 steps per minute band (919 +/- 511 vs -98 +/- 697, P < 0.001), and within the 101-120 steps per minute band (415 +/- 625 vs -327 +/- 467, P < 0.001) versus the AC group. PAT-RHI significantly increased in the PASR group (0.179 +/- 0.180 vs 0.0.044 +/- 0.101, P = 0.019), whereas no significant changes were observed in PAT-AIx. Conclusions Modest improvements in microvascular reactivity, PA, sedentary behavior, but not arterial stiffness were demonstrated after a 12-wk intervention targeting sedentary behavior reduction and increased lifestyle PA in individuals with APAD.