Exercise may be better than stents for PAD patients

November 16, 2011 in Cardiology

Supervised exercise was shown to be more effective than stenting or medication for improved walking ability in patients with peripheral artery disease. The findings from a national study were reported today at the 2011 American Heart Association Scientific Sessions meeting. Rhode Island Hospital is one of hospitals participating in the national CLEVER study.

Peripheral artery disease (PAD) is a condition in which plaque builds up in the arteries and impacts blood flow, especially to the legs. It is estimated that between 10 and 12 million people suffer from PAD in the United States. One symptom of PAD is known as claudication, a painful cramping of the that limits the patient's ability to walk. It affects nearly 2 million people who suffer from PAD, and results in a and poor quality of life.

Current guidelines for the treatment of claudication include pharmacotherapy, rehabilitation and lower extremity revascularization using stents. Timothy Murphy, M.D., a radiologist who heads the vascular disease research center at Rhode Island Hospital, was the principal investigator for the Rhode Island Hospital arm of the CLEVER (Claudication: Exercise Versus. Endoluminal Revascularizaton) Study, a multi-center study sponsored by grants from the National Heart Lung and Blood Institute. It is the first multi-center clinical trial to compare the treatment strategies. He is also the lead author of the paper published in the November issue of the journal Circulation.

The research group reported that of 111 patients studied in the , the most effective treatment proved to be supervised exercise based on the results of a treadmill test taken at baseline and again at six months. Patients who were in the supervised improved by a mean of 4.6 minutes in the treadmill test, while the group who received stents improved by a mean of 2.5 minutes. The researchers also found, however, that self-reported quality of life measurements proved to be higher in the group who received stents, even though their ability to walk did not improve as greatly as the group who received supervised exercise rehabilitation.

Murphy says, "This study demonstrates that for patients with claudication that supervised exercise provides a superior improvement in treadmill walking performance compared to both primary aortoiliac stenting and optimal medical care. This benefit is associated with an improvement in self-reported walking distance, an increase in HDL and a decrease of fibrinogen." He adds, however, "Secondary measures of treatment efficacy such as self-reported physical function measures and pedometer measures of community walking favored primary over supervised exercise."

Alan T. Hirsch, M.D., of the Lillehei Heart Institute at the University of Minnesota Medical School, presented the findings today. Hirsch comments, "At a time when health care costs are appropriately in sharp public focus, this study provides an avenue by which we could -- if we choose -- achieve a major positive set of health outcomes at low risk and at lower cost."

Murphy and the researchers believe that more studies are necessary, but also believe that supervised exercise may be an effective recommended treatment for PAD patients with . Murphy comments, "The CLEVER team will be reporting further outcomes from this study based on an 18-month review."

Provided by Lifespan search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Study identifies superior hypertension treatment, efficacy between sexes

(Medical Xpress)—In a recent subgroup analysis of the largest blood pressure treatment trial in history, University of Alabama at Birmingham (UAB) researchers found that women and men react the same to ...

Cardiology created 7 hours ago | popularity 5 / 5 (1) | comments 0

Evaluating a new way to open clogged arteries

Over the past few decades, scientists have developed many devices that can reopen clogged arteries, including angioplasty balloons and metallic stents. While generally effective, each of these treatments ...

Cardiology created 8 hours ago | popularity 4.8 / 5 (4) | comments 0 | with audio podcast

Biomarker trio predicts near-term heart risk

(Medical Xpress)—Cardiologists have identified a trio of biomarkers that may predict which patients with heart disease have a high risk of heart attack or death in the next two years.

Cardiology created 9 hours ago | popularity 4 / 5 (1) | comments 0 | with audio podcast

Hospitals' cardiac arrest incidence and survival rates go hand in hand

Hospitals with the highest rates of cardiac arrests tend to have the poorest survival rates for those cases, new University of Michigan Health System research shows.

Cardiology created 23 hours ago | popularity not rated yet | comments 0

Effect of fluid and sodium restrictions on weight loss among patients with heart failure

A clinical trial of 75 patients hospitalized with acute decompensated heart failure (ADHF) suggests that aggressive fluid and sodium restriction has no effect on weight loss or clinical stability at three days but was associated ...

Cardiology created 23 hours ago | popularity not rated yet | comments 0


Genetic variation among patients with pulmonary fibrosis associated with improved survival

Variation in the gene MUC5B among patients with idiopathic pulmonary fibrosis was associated with improved survival, according to a study published online by JAMA. The study is being released early online to coincide with i ...

Genetic risk for obesity found in many Mexican young adults

As many as 35 percent of Mexican young adults may have a genetic predisposition for obesity, said a University of Illinois scientist who conducted a study at the Universidad Autónoma de San Luis Potosί.

Low radiation scans help identify cancer in earliest stages

A study of veterans at high risk for developing lung cancer shows that low-dose computed tomography (LDCT) can be highly effective in helping clinicians spot tiny lung nodules which, in a small number of patients, may indicate ...

Shorter duration steroid therapy may offer similar effectiveness in reducing COPD exacerbations

Among patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospital admission, a 5-day glucocorticoid treatment course was non-inferior (not worse than) to a 14-day course with regard ...

Race and gender influence diagnosis of COPD

African-Americans are less likely than whites and women are more likely than men to have had a prior diagnosis of chronic obstructive pulmonary disease (COPD) regardless of their current disease severity, according to a new ...

If you can remember it, you can remember it wrong

(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...