Walk Your Heart to Health

Peripheral artery disease patients should consider walking instead of stenting

(RxWiki News) Hold off on getting a stent if you suffer from peripheral artery disease (PAD). A simpler and less invasive supervised exercise program may better improve walking ability in patients with clogged blood vessels to the legs.

Both the exercise program and angioplasty to open clogged arteries and stenting were found to improve walking ability better than the standard therapy of walking at home and taking Pletal (Cilostazol) to improve blood flow.

"Ask your doctor if supervised exercise would be beneficial for PAD."

Dr. Timothy Murphy, study lead author and professor in the diagnostic-imaging department at the Warren Alpert Medical School of Brown University, said that evidence suggests that patients who receive the usual medical care do not enjoy a substantial improvement in their symptoms.

About 2 million of the 9 million who suffer from PAD suffer from leg muscle pain when they exercise. The use of stents has increased, and exercise is encouraged less frequently, but the effectiveness of the various treatments was unclear.

During the study, called CLaudication: Exercise Vs Endoluminal Revascularization Study (CLEVER, researchers enrolled 111 PAD patients with an average age of 64 from 29 U.S. medical centers. Just over 60 percent were men. More than half smoked and about 25 percent had diabetes.  The study began in 2007 and will conclude in January 2012 after 18 months of follow up.

Patients were randomly assigned to walking at home and taking Cilostazol, or the same approach with the addition or supervised treadmill exercise or stent placement to reduce artery narrowing.

After six months patients in the supervised exercise program had significantly increased their walking time on a treadmill as did patients who received stents. Participants who exercised at home showed little improvement.

Among the group that took medication and engaged in supervised exercise, their walking time improved by 5.8 minutes, while the stenting group improved by 3.7 minutes. The home exercise group improved by 1.2 minutes.

Patients in both the supervised exercise and stent groups scored better on a variety of quality of life measurements., but those in the stent group described a better quality of life compared to the supervised- or home-exercise programs.

The research was recently presented at the American Heart Association's annual meeting in Orlando, Fla., and also simultaneously published in Circulation: Journal of the American Heart Association.

Review Date: 
November 16, 2011