Ankle Readings Foretell Walking Problems

[Guest guest]

http://www.forbes.com/lifestyle/health/feeds/hscout/2004/07/27/hscout520315.

html

A test that checks blood pressure in the ankle as well as the arm can warn

of a future loss of mobility caused by blockage of the leg arteries, even if

that blockage is causing no obvious problems...

The most significant finding was that the loss of mobility occurred in

people who were not experiencing intermittent claudication, the leg pain

that is the classic symptom of what is formally called peripheral arterial

disease (PAD), said study leader Dr. McGrae McDermott, an associate

professor of medicine at Northwestern.

As expected, the people with PAD whose legs hurt them after they walked for

a while did have a greater reduction in walking endurance than people

without PAD. But the study also found patients whose PAD was causing no

symptoms " had significantly greater declines in six-minute walk performance

than did participants without PAD. "

That finding suggests the need to screen everyone aged 70 and older for PAD,

and to do that screening starting at age 59 for smokers and people with

diabetes, who are at increased risk of leg artery blockage...

The basic treatment is simple, McDermott said: walking, preferably in a

controlled situation.

" Supervised treadmill walking appears to be the best, with a nurse or

physiologist present, for 30 minutes three times a week, " she said,

acknowledging that " even if you walk at home, you can get some benefit. "

It has been thought that people with symptom-free PAD did not suffer any

deterioration in walking endurance, McDermott said. It now appears that

those people were reporting no trouble simply because their condition caused

them to walk less, she said.

" When you walk slower, you don't feel pain, but you decrease your functional

capacity, " said Dr. A. Stein, associate chairman of medicine at Beth

Israel Medical Center in New York City and a spokesman for the American

Heart Association.

Treatment for PAD, even if it causes no symptoms, is helpful for more than

just walking, McDermott said. The condition is associated with an increased

risk of heart attack, stroke and other cardiovascular problems.

It is important to detect those patients because PAD, like any other

artery-blocking condition, will progress steadily unless treated, possibly

leading to gangrene that requires amputation, Stein said.

An essential treatment is " vigorous, vigorous " control of risk factors such

as blood cholesterol level and smoking, Stein said. But doctors are starting

to use some of the same techniques employed for blockage of heart arteries,

such as implanting stents, flexible tubes that keep blood flowing, Stein

added.