ABC | Volume 113, Nº3, September 2019

Original Article Gerage et al. Physical activity in PAD patients Arq Bras Cardiol. 2019; 113(3):410-416 Table 1 – Characteristics of peripheral artery disease patients according to gender (n = 174) Values Age (years) 66.7 (9.0) Gender (% men) 61.5 Still working (%) 20.5 Time of disease diagnosis (yrs.) 7.9 (5.8) Ankle-brachial index 0.61 (0.18) Claudication distance (m) † 135.9 (82.4) Six-minute walking distance (m) 326.6 (92.7) WIQ distance (score) 22.7 (22.2) WIQ speed (score) 23.2 (15.6) WIQ stairs (score) 30.7 (25.3) WELCH (score) 27.3 (19.1) Comorbidities and risk factors Charlson index (score) 3.0 (1.7) Current smokers (%) 18.1 Hypertension (%) 88.9 Dyslipidemia (%) 85.2 Diabetes (%) 52.4 Obesity (%) 28.6 Coronary artery disease (%) 34.5 Heart failure (%) 13.6 Cancer (%) 14.9 Medications Antihypertensive (%) 78 Antidiabetic (%) 43 Vasodilator (%) 29 Lipid-lowering (%) 89 Antiplatelet agent (%) 85 Antidepressants (%) 20 Medications Cardiac (%) 24 Vascular (%) 12 WIQ: Walking Impairment Questionnaire; WELCH: Walking Estimated- Limitation Calculated by History. diagnosis, ankle-brachial index, and six-minute walking distance) association between adherence to physical activity recommendation and sociodemographic data and clinical factors. The results are expressed as odds ratios (OR) and their respective 95% confidence intervals (95%CI). For all the statistical analyses, significance was set at p < 0.05. Results The overall characteristics of patients are shown in Table 1. The mean age of all patients was 66.7 ± 9.0 years and, on average, patients had moderate disease (ABI: 0.61 ± 0.18). Most patients hadhypertension (88.9%), dyslipidemia (85.2%) and diabetes (52.4%),and used antihypertensive (78%) (i.e. thiazide diuretics, calcium channel blockers, angiotensin‑converting enzyme inhibitors, angiotensin II receptor antagonists, beta- blockers), lipid-lowering (89%) (i.e. statins) and antiplatelet agent drugs (85%) (i.e. irreversible cyclooxygenase inhibitors, adenosine diphosphate receptor inhibitors). Forty‑three percent of the patients used antidiabetic (i.e. sulfonylureas, metformin, thiazolidinediones, alpha-glucosidase inhibitors, meglitinides), 29% used vasodilator (i.e. hydralazine and minoxidil) and 20% used antidepressant drugs (i.e. sertraline, fluoxetine, citalopram, escitalopram, paroxetine). Figure 1 depicts the distribution of time spent in sedentary, low‑light, high-light and moderate/vigorous activities. Patients, agedbetween43and96years,spentinaverage640±121min/day, 269 ± 94 min/day, 36 ± 27 min/day and 15 ± 16 min/day in sedentary, low-light, high-light and moderate/vigorous physical activities, respectively. Most patients (52.9%) spent less than 10 min in moderate/vigorous physical activities (sporadic, non-bouted) per day. Table 2 depicts data about sedentary bouts (< 100 counts), bouts of high light and MVPA (≥ 1041 counts) and bouts only of MVPA (≥ 1952 counts). Ninety percent of patients spent at least 10 bouts in sedentary behavior per day and, on average, the total duration of this bout was 413.7 ± 151.1 min/day. Ontheotherhand,sedentarybreakslasted174.4±51.4min/day. Thirty-one percent of patients did not accumulate 10 or more consecutive minutes a week, at least, in high-light physical activities. Considering only MVPA, 67.7% of patients did not accumulate 10 consecutive minutes (bouts) or more at this intensity of physical activity during a week. Among those patients who spent at least one bout of MVPA, the duration of this bout was 9.7 ± 9.6 min/day. The prevalence of patients who achieved physical activity recommendations for the overall population (≥ 150 min/week of MVPA in bouts of 10 minutes or more) was only 3.4%. Stratifying by age (Figure 2), this prevalence was 11.1% in those under 60 years old, 2.9% in those between 60 and 64 years old, and 1% in those over 65 years. No patients over 70 years old achieved the physical activity recommendations for the overall population. Table 3 shows crude and adjusted association between adherence to physical activity recommendations and sociodemographic and clinical characteristics in PAD patients. After adjustment for confounders, an inverse and significant association was observed between adherence to physical activity recommendation and age (OR = 0.867; p = 0.011), which means that for each year of life, the odds are ~13% less to meet the physical activity recommendations. Time of disease diagnosis, ABI and total walking distance were not associated with this adherence criterion (p > 0.05). Discussion The main findings of the present study were: a) Brazilian PAD patients with intermittent claudication symptoms spent most part of the day in sedentary behaviors with a short time in MVPA; b) only 3.4% of the patients met the physical activity 412