Key result
Upper extremity pain linked to ~2.6-fold higher odds of elevated MAP after lower limb loss.
Why the study?
Factors associated with mean arterial pressure and pulse pressure after lower limb loss, while considering non-modifiable factors, needed identification.
Cross-Sectional (n=206)
No
Answers are grounded in this paper and cite their sources.
Over half of adults with lower limb loss and no prior MACE have elevated mean arterial pressure or wide pulse pressure, which are associated with pain, heart rate, age, and physical activity, suggesting underlying cardiovascular risk.
Objectives: This study aimed to identify factors associated with mean arterial pressure and pulse pressure, while considering non-modifiable factors. Methods: This study was a retrospective cross-sectional analysis of adults with lower limb loss and no history of a major adverse cardiovascular event. Participants completed self-reported medical histories and outcome measures, including a report of pain extent per body diagrams and physical activity per the General Practice Physical Activity Questionnaire. During an onsite clinical evaluation, participants underwent a resting vital sign assessment by a physiatrist and/or physical therapist. Forward stepwise logistic regression models were run to identify the factors associated with elevated mean arterial pressure (i.e., >100 mmHg) and wide pulse pressures (i.e., >60 mmHg). Results: Of 206 participants (aged 54.5 ± 14.1 years; 74.3% male; 72.8% White; 42.2%; dysvascular etiology), n = 107 (51.9%) presented with an elevated mean arterial pressure and n = 52 (25.2%) had a wide pulse pressure. Forty-two participants (20.4%) presented to the clinic with both conditions. A mean arterial pressure > 100 mmHg was associated with upper extremity pain presence [odds ratio (OR) = 2.62, 95% confidence interval (CI) = 1.26–5.45, p = 0.010] and increasing heart rate (OR = 1.02, CI = 1.00–1.04, p = 0.033). A pulse pressure > 60 mmHg was associated with advancing age (OR = 1.07, 95%CI = 1.04–1.10, p < 0.001) and a lower physical activity level (OR = 1.50, 95%CI = 1.07–2.11, p = 0.017). Conclusions: Over 50% of adults with lower limb loss and no history of major adverse cardiovascular events have an elevated mean arterial pressure and/or wide pulse pressure, suggesting maladaptive cardiovascular changes. Factors associated with elevated mean arterial pressure and/or wide pulse pressure may suggest underlying cardiovascular disease and sympathetic overactivity, warranting a further evaluation of cardiovascular risk.
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Stauffer et al. (2025) conducted a cross-sectional in Lower limb loss without history of major adverse cardiovascular events (n=206). Upper extremity pain vs. No upper extremity pain was evaluated on Elevated mean arterial pressure (>100 mmHg) (OR 2.62, 95% CI 1.26-5.45, p=0.010). Among adults with lower limb loss, the presence of upper extremity pain was significantly associated with an elevated mean arterial pressure (OR 2.62).
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