TY - JOUR
T1 - Community walking speed, sedentary or lying down time, and mortality in peripheral artery disease
AU - McDermott, Mary M.
AU - Guralnik, Jack M.
AU - Ferrucci, Luigi
AU - Tian, Lu
AU - Kibbe, Melina R.
AU - Greenland, Philip
AU - Green, David
AU - Liu, Kiang
AU - Zhao, Lihui
AU - Wilkins, John T.
AU - Huffman, Mark D.
AU - Shah, Sanjiv J.
AU - Liao, Yihua
AU - Gao, Ying
AU - Lloyd-Jones, Donald M.
AU - Criqui, Michael H.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: grants # R01-HL071223, R01-HL076298, R01-HL109244, R01-HL083064, R01-HL64739 and R01-HL089619 from the National Heart, Lung, and Blood Institute. Supported in part by the Intramural Research Program, National Institute on Aging, NIH.
Publisher Copyright:
© The Author(s) 2016.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - We studied whether slower community walking speed and whether greater time spent lying down or sleeping were associated with higher mortality in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) < 0.90 were identified from Chicago medical centers. At baseline, participants reported their usual walking speed outside their home and the number of hours they spent lying down or sleeping per day. Cause of death was adjudicated using death certificates and medical record review. Analyses were adjusted for age, sex, race, comorbidities, ABI, and other confounders. Of 1314 PAD participants, 189 (14.4%) died, including 63 cardiovascular disease (CVD) deaths. Mean follow-up was 34.9 months ± 18.1. Relative to average or normal pace (2-3 miles/hour), slower walking speed was associated with greater CVD mortality: no walking at all: hazard ratio (HR) = 4.17, 95% confidence interval (CI) = 1.46-11.89; casual strolling (0-2 miles/hour): HR = 2.24, 95% CI = 1.16-4.32; brisk or striding (>3 miles/hour): HR = 0.55, 95% CI = 0.07-4.30. These associations were not significant after additional adjustment for the six-minute walk. Relative to sleeping or lying down for 8-9 hours, fewer or greater hours sleeping or lying down were associated with higher CVD mortality: 4-7 hours: HR = 2.08, 95% CI = 1.06-4.05; 10-11 hours: HR = 4.07, 95% CI = 1.86-8.89; <12 hours: HR = 3.75, 95% CI = 1.47-9.62. These associations were maintained after adjustment for the six-minute walk. In conclusion, slower walking speed outside the home and less than 8 hours or more than 9 hours lying down per day are potentially modifiable behaviors associated with increased CVD mortality in patients with PAD.
AB - We studied whether slower community walking speed and whether greater time spent lying down or sleeping were associated with higher mortality in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) < 0.90 were identified from Chicago medical centers. At baseline, participants reported their usual walking speed outside their home and the number of hours they spent lying down or sleeping per day. Cause of death was adjudicated using death certificates and medical record review. Analyses were adjusted for age, sex, race, comorbidities, ABI, and other confounders. Of 1314 PAD participants, 189 (14.4%) died, including 63 cardiovascular disease (CVD) deaths. Mean follow-up was 34.9 months ± 18.1. Relative to average or normal pace (2-3 miles/hour), slower walking speed was associated with greater CVD mortality: no walking at all: hazard ratio (HR) = 4.17, 95% confidence interval (CI) = 1.46-11.89; casual strolling (0-2 miles/hour): HR = 2.24, 95% CI = 1.16-4.32; brisk or striding (>3 miles/hour): HR = 0.55, 95% CI = 0.07-4.30. These associations were not significant after additional adjustment for the six-minute walk. Relative to sleeping or lying down for 8-9 hours, fewer or greater hours sleeping or lying down were associated with higher CVD mortality: 4-7 hours: HR = 2.08, 95% CI = 1.06-4.05; 10-11 hours: HR = 4.07, 95% CI = 1.86-8.89; <12 hours: HR = 3.75, 95% CI = 1.47-9.62. These associations were maintained after adjustment for the six-minute walk. In conclusion, slower walking speed outside the home and less than 8 hours or more than 9 hours lying down per day are potentially modifiable behaviors associated with increased CVD mortality in patients with PAD.
KW - cardiovascular mortality
KW - cardiovascular risk factors
KW - intermittent claudication
KW - modifiable behaviors
KW - peripheral artery disease
KW - physical activity
KW - sedentary
KW - six-minute walk test
UR - http://www.scopus.com/inward/record.url?scp=84961244414&partnerID=8YFLogxK
U2 - 10.1177/1358863X15626521
DO - 10.1177/1358863X15626521
M3 - Article
C2 - 26873873
AN - SCOPUS:84961244414
SN - 1358-863X
VL - 21
SP - 120
EP - 129
JO - Vascular Medicine
JF - Vascular Medicine
IS - 2
ER -