Effects of clustered comorbid conditions on walking capacity in patients with peripheral artery disease

BACKGROUND: Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PAD patients. Therefore, the aim of this study was to analyze the influence of clustered comorbid conditions on walking capacity in PAD patients.

METHODS: This cross-sectional study included 415 PAD patients (155 women and 260 men with an average age of 63 years). Claudication distance and total walking distance were assessed with the graded maximal treadmill test. Medical histories of hypertension, diabetes, cerebrovascular disease (CVD), coronary artery disease (CAD), and chronic obstructive pulmonary disease (COPD) were obtained. Binary logistic regression was carried out to analyze whether clustered comorbid conditions were associated with walking capacity.

RESULTS: CVD was associated with lower total walking distance (odds ratio [OR] = 2.45; 95% confidence interval [CI]: 1.11-5.39). The cluster hypertension, diabetes, CVD, CAD, and COPD were associated with a lower claudication distance (OR = 7.63; 95% CI: 1.42-40.96). In addition, the clusters of CVD and hypertension (OR = 3.16; 95% CI: 1.38-7.23), CVD and CAD (OR = 3.46; 95% CI: 1.25-9.57), CVD, hypertension, and diabetes (OR = 11.38; 95% CI: 2.27-57.00) were associated with a lower total walking distance.

CONCLUSIONS: CVD was associated with walking impairment of IC patients and in particular when CVD is clustered with other comorbid conditions.