Does Physical Activity Prevent Peripheral Vascular Disease?: The Framingham Experience

Abstract

PURPOSE: Physical activity (PA) has been shown to prevent many conditions and treat many others. While it is an effective treatment for peripheral vascular disease (PVD), no studies have analyzed the effect of PA in preventing PVD. METHODS: Men and women in the Framingham Heart Study have been examined biannually since 1948 for the presence of PVD and other cardiovascular diseases (CVD) as well as for CVD risk factors (smoking, Metropolitan weight, cholesterol level, systolic blood pressure, glucose intolerance, and left ventricular hypertrophy). PA was assessed in 1956–58 using the previously validated Framingham Physical Activity Index. Subjects were ranked based on weighted PA levels, then grouped into quartiles. We examined the incidence of PVD at 20 and 36 years of follow-up, adjusting for baseline levels of CVD risk factors and for the presence of other CVD. We included the 1745 men and 2220 women free of PVD and CVD at baseline who answered the physical activity questions and survived to at least the first follow-up. RESULTS: Among those free of other CVD, the incidence of PVD at 20 and 36 years of follow-up was 4.3% and 5.3% in men and 2.3% and 4.5% in women. Including those who developed other CVD first, the incidence of PVD at 20 and 36 years of follow-up was 6.6% and 11.1% in men and 3.9% and 7.9% in women. For both men and women, there was no difference in the incidence of PVD between the least active quartile and any of the three more active quartiles. This lack of a difference held up in both the analyses adjusted only for age and in those adjusted for CVD risk factors. There was also no difference whether or not patients with other CVD were included in the analysis. CONCLUSION: We conclude that while PA may be an effective treatment for PVD, it does not appear to prevent PVD.