Abstract
In patients with peripheral artery disease (PAD), the blood supply directed to the lower limbs is reduced. This results in severe limb ischemia and thereby intermittent claudicating which is characterized by pain in lower limbs that occurs with walking and is relieved by rest. Of note, PAD can extremely affect the quality of living of patients and increase high risk of coronary and cerebral vascular accidents. However, effective treatments of PAD are still challenging in clinics. A number of reports have demonstrated the beneficial effects of supervised exercise on symptoms of PAD patients. This review will summarize results obtained from recent human and animal studies, which include the abnormalities in sympathetic control of blood pressure response during exercise in PAD, and rationality of animal models used for study human PAD. Nonetheless, additional in-depth studies are necessary to better explore the underlying mechanisms of the exaggerated responses of sympathetic nerve and blood pressure in PAD at molecular and cellular levels.
Highlights
Peripheral artery disease (PAD) is a common and disabling disease affecting 12 to 20% of Americans over age 60 [1,2]
PAD patients are at high risk of myocardial infarctions, cerebral vascular high risk of myocardial infarctions, cerebral vascular accidents and all-cause mortality [3] with a death rate similar to that seen in patients with coronary or cerebral vascular disease
The first termed “Central Command” [16], suggests that motor and sympathetic activation occur in parallel, i.e. there is a volitional signal emanating from central motor areas that leads to increased sympathetic activation during exercise
Summary
Peripheral artery disease (PAD) is a common and disabling disease affecting 12 to 20% of Americans over age 60 [1,2]. The classic discomfort syndrome of PAD is termed “intermittent claudication” which is characterized by pain in lower limbs that occurs with walking and is relieved by rest. Angioplasty or surgery is necessary to treat PAD causing claudicating These procedures can improve the affected artery and increase blood flow to the affected tissues. Symptom-relief drugs such as cilostazol increase blood flow to the limbs by widening the blood vessels and increasing the thin blood, which helps improve symptoms of claudication and leg pain in PAD patients. Identifying the molecular mediators that can decrease the exaggerated BP responses to exercise in PAD patients has clear clinical relevance
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