Longitudinal Changes in Physical Activity Levels and Cardiovascular Risk Parameters in Patients with Symptomatic Peripheral Artery Disease

Background: Previous cross-sectional studies have demonstrated that physical activity is associated with lower cardiovascular risk in patients with peripheral artery disease (PAD). However, it is not possible to establish causality, and longitudinal design studies are required. Objective: To analyze the changes in cardiovascular risk parameters and physical activity levels after a 2-year follow-up in patients with symptomatic PAD. Methods: This study started in 2015. In the first phase, 268 patients were included. In the second phase, after 2 years (median = 26 months), 72 patients were re-evaluated. Cardiovascular risk parameters, such as blood pressure, cardiac autonomic modulation, and arterial stiffness, and physical activity levels were measured at baseline and after 2 years of follow-up. Association among delta changes (values from follow-up - baseline) in physical activity and cardiovascular parameters were analyzed by multiple linear regression. The significance level was set at p < 0.05. Results: Patients reduced their total physical activity levels compared to baseline (baseline = 2257.6 +/- 774.5 versus follow-up = 2041 +/- 676.2 min/week, p = 0.001). After follow-up, ankle-brachial index (0.62 +/- 0.20 versus 0.54 +/- 0.20, p = 0.003), and standard deviation of all RR intervals (43.4 +/- 27.0 versus 25.1 +/- 13.4 ms, p < 0.001) were lower, whereas carotid-femoral pulse wave velocity was higher (9.0 +/- 3.0 versus 10.7 +/- 3.4 m/s, p = 0.002) compared to baseline values. We did not observe any association among delta values of physical activity levels and cardiovascular risk parameters. Conclusion: Patients with PAD had reduced physical activity levels and impaired cardiovascular risk parameters during 2-year follow-up.