Key result
Maximal incremental bicycle exercise induced age-dependent changes in ankle systolic blood pressure and ankle brachial index, demonstrating that AHA limits for post-exercise ABI are inadequate.
Why the study?
Does incremental maximal bicycle exercise affect post-exercise ankle brachial index and ankle systolic blood pressure across different age groups in physically active asymptomatic patients?
Observational (n=726)
Does incremental maximal bicycle exercise affect post-exercise ankle brachial index and ankle systolic blood pressure across different age groups in physically active asymptomatic patients?
p-value: p=<.05
Post-exercise ABI and ASBP changes following maximal incremental bicycle testing are highly age-dependent, suggesting current AHA diagnostic thresholds for PAD may be inadequate in active patients.
May warrant age-specific post-exercise ABI thresholds in active adults; hypothesis-generating and should not yet change practice.
The American Heart Association (AHA) recommendations for diagnosing peripheral artery disease (PAD) after exercise are a decrease >20% of ankle brachial index (ABI) or >30 mm Hg of ankle systolic blood pressure (ASBP) from resting values. We evaluated ABI and ASBP values during incremental maximal exercise in physically active and asymptomatic patients. Patients (n = 726) underwent incremental bicycle tests with pre- and post-exercise recording of all four limbs arterial pressures simultaneously. Univariate and multivariate analyses were performed to define the correlation between post-exercise ABI with various clinical factors, including age. Thereafter, the population was divided into groups of age: less than 40 (G < 40), from 40 to 44 (G40/44) from 45 to 49 (G45/49), from 50 to 54 (G50/54), from 55 to 59 (G55/59), from 60 to 64 (G60/64), and 65 and above (G ≥ 65) years. Results are mean ± SD. * is two-tailed P < .05 for ANOVA with Dunnett's post-hoc test from G40. Changes from rest in ASBP were -3 ± 22 (G < 40), -2 ± 20 (G40/44), 4 ± 22* (G45/49), 10 ± 25* (G50/54), 18 ± 21* (G55/59), 23 ± 27* (G60/64), and 16 ± 22* (G ≥ 65) mm Hg. Decreases from rest in ABI were 32 ± 9 (G < 40), 33 ± 9 (G40/44), 29 ± 8 (G45/49), 27 ± 10* (G50/54), 24 ± 7* (G55/59), 22 ± 12* (G60/64), and 21 ± 12* (G ≥ 65) % of resting ABI. Maximal incremental exercise results in ABI and ASBP changes are mostly dependent on age. The AHA limits for post-exercise ABI are inadequate following maximal incremental bicycle testing. Future studies detecting PAD in active patients should account for the effect of age.
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Godet et al. (2018) conducted an observational in Physically active and asymptomatic (n=726). Incremental maximal bicycle exercise vs. Resting values was evaluated on Changes from rest in ankle systolic blood pressure (ASBP) and ankle brachial index (ABI) (p=<.05). Maximal incremental bicycle exercise induced age-dependent changes in ankle systolic blood pressure and ankle brachial index, demonstrating that AHA limits for post-exercise ABI are inadequate.
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