[Relationship between physical activity during leisure time and progression of ankle-brachial index]. / Relación entre la actividad física en el tiempo libre y la progresión del índice tobillo-brazo.

OBJECTIVE: To study the relationship between physical activity during leisure time and progression of ankle-brachial index (ABI) in the Spanish general population. METHOD: Prospective, multicentre cohort study with 1941 subjects over 49 years of age, free of peripheral arterial disease at the time of recruitment of the cohort, were studied. Physical activity during leisure time variable was obtained using the VREM questionnaire. Peripheral arterial disease was considered to be an ankle-brachial index (ABI) <0.9. A multivariate logistic regression analysis was performed to evaluate the independent association between physical activity during leisure time and ABI. RESULTS: The mean age was 63.4 years and 54.6% were women. In the multivariate analysis, there was a positive relationship between physical activity during leisure time and ABI in patients with an energy consumption of more than 5000 MET in 14 days (odds ratio: 0.37; 95% confidence interval: 0.18-0.80). These specific activities doing sports or dancing, going shopping on foot, and cleaning the house for more than an hour a day showed a protective effect. In the group of subjects who maintained the physical activity during leisure time during the time of the research, a protective effect was observed with overall physical activity (MET) and going shopping on foot. CONCLUSIONS: In our research, PALT was favorably associated with ABI, in a sample of the Spanish general population that is very active and has a low-cardiovascular risk.

[Underdiagnosis of peripheral arterial disease in the Spanish population. ARTPER study]. / Infradiagnóstico de la arteriopatía periférica en la población española. Estudio ARTPER.

BACKGROUND AND OBJECTIVES: Although peripheral arterial disease (PA) is an important clinical marker of cardiovascular morbimortality, the rate of under-diagnosis is unknown. Our aimed to know the proportion of patients underdiagnosed of PA and the associated factors. PATIENTS AND METHODS: 3786 patients >49 years old, randomly selected, were studied. PA was diagnosed by means of the ankle-brachial index (ABI<0, 9). Underdiagnosed was considered when ABI<0, 9 and when they were not diagnosed of PA in the clinical record. We also determined the presence of intermittent claudication (IC) defined by Edinburgh's questionnaire. RESULTS: 7,6% had an ABI <0, 9 (IC95% 6.7-8.4). Of these patients 80.7%, were underdiagnosed, although the 29.3% had IC. PA underdiagnosis was low in current smokers or former smokers (OR 0.20; IC95% 0.07-0.59), if IC (OR 0.40; IC95% 0.18-0.89), if ABI between <0.7 and 0.5 (OR 0.36; IC95% 0.16-0.81) or <0,5 (OR 0.04; IC95 % 0.01-0.20), being higher in >70 years (OR 3.12; IC95% 1.12-8.67). CONCLUSIONS: PA underdiagnosis is high, especially in old patients. It is necessary to reach consensus criteria for the practice of the ABI in the general population.

Relación entre la actividad física en el tiempo libre y la progresión del índice tobillo-brazo / Relationship between physical activity during leisure time and progression of ankle-brachial index

Objetivo: Estudiar la relación entre la actividad física en el tiempo libre y la progresión del índice tobillo-brazo (ITB) en población general española. Método: Estudio de cohortes prospectivo y multicéntrico, con 1941 sujetos mayores de 49 años, libres de arteriopatía periférica en el momento del reclutamiento. La variable actividad física en el tiempo libre se obtuvo mediante el cuestionario VREM ((Versión Reducida en Espãnol del Cuestionario de Actividad Física en el Tiempo Libre de Minnesota). Se consideró arteriopatía periférica un ITB <0,9. Para evaluar la asociación independiente entre la actividad física en el tiempo libre y el ITB se utilizaron modelos de regresión logística multivariante. Resultados: La edad media era de 63,4 años y el 54,6% eran mujeres. En el análisis multivariante hubo una relación positiva entre la actividad física en el tiempo libre y el ITB en pacientes con un gasto energético de más de 5000 metabolic energy turnover (MET) en 14 días (odds ratio: 0,37; intervalo de confianza del 95%: 0,18-0,80). Por actividades específicas, mostraron un efecto protector hacer deporte o bailar, ir a comprar a pie y limpiar la casa más de 1 hora al día. En el grupo de personas que mantenían a largo plazo la realización de actividad física en el tiempo libre se observó un efecto protector en la actividad física en general (MET) y en ir a comprar a pie. Conclusiones: En nuestro estudio, en una muestra de población general española muy activa, la actividad física en el tiempo libre se asoció favorablemente con el ITB. (AU)

Objective: To study the relationship between physical activity during leisure time and progression of ankle-brachial index (ABI) in the Spanish general population. Method: Prospective, multicentre cohort study with 1941 subjects over 49 years of age, free of peripheral arterial disease at the time of recruitment of the cohort, were studied. Physical activity during leisure time variable was obtained using the VREM questionnaire. Peripheral arterial disease was considered to be an ankle-brachial index (ABI) <0.9. A multivariate logistic regression analysis was performed to evaluate the independent association between physical activity during leisure time and ABI. Results: The mean age was 63.4 years and 54.6% were women. In the multivariate analysis, there was a positive relationship between physical activity during leisure time and ABI in patients with an energy consumption of more than 5000 MET in 14 days (odds ratio: 0.37; 95% confidence interval: 0.18-0.80). These specific activities doing sports or dancing, going shopping on foot, and cleaning the house for more than an hour a day showed a protective effect. In the group of subjects who maintained the physical activity during leisure time during the time of the research, a protective effect was observed with overall physical activity (MET) and going shopping on foot. Conclusions: In our research, PALT was favorably associated with ABI, in a sample of the Spanish general population that is very active and has a low-cardiovascular risk. (AU)

[The relationship between physical activity in leasure time and the ankle-brachial index in a general Spanish population: The ARTPER study]. / Relación entre actividad física en el tiempo libre y el índice tobillo-brazo en población general española: estudio ARTPER.

BACKGROUND AND OBJECTIVE: High levels of daily physical activity have been shown to be linked to decreased functional impairment in peripheral artery disease (PAD) patients and positively related to the ankle brachial index (ABI) in subjects without PAD. The aim of this study was to examine the relationship between leisure time physical activity (LTPA) and the ABI in a general population. MATERIAL AND METHOD: Baseline data from the ARTPER study cohort corresponding to 2,840 subjects>49 years from Barcelona were analyzed. The LTPA variable was obtained through the validated Spanish short version of the Minnesota Leisure Time Physical Activity Questionnaire. ABI<0.9 was taken to indicate PAD. Multivariate logistic regression analysis was performed to evaluate the independent association between LTPA and PAD. RESULTS: Subjects with more LTPA were younger, female, less smokers, and suffered fewer PAD. Total activity, measured in metabolic energy turnover (MET) and the LTPA hours, was significantly higher in subjects without PAD (P<.001). There was an inverse relationship between LTPA and the risk of suffering PAD (odds ratio 0.56, 95% confidence interval 0.38-0.81 for those who expended 2,700 METs or more in 14 days) adjusting for confounding factors. CONCLUSIONS: In our study, LTPA was positively related to the ABI, with those with PAD being the ones with less LTPA.

[Validation of a Spanish Short Version of the Minnesota Leisure Time Physical Activity Questionnaire (VREM)]. / Validación de una versión reducida en español del cuestionario de actividad física en el tiempo libre de Minnesota (VREM).

BACKGROUND: The aim of this study is to develop and validate a shorter version (VREM) of the Spanish version of the Minnesota leisure time Physical Activity Questionnaire (CAFM), in order to have a shorter physical activity questionnaire to be used in Primary Care. METHODS: Descriptive study of validation of a new physical activity measurement questionnaire. 200 patients older than 50, who visited one of 5 primary care centers in Barcelona for any reason were selected, with age-sex Catalonia's distribution. Two phases: first, VREM construction through items reduction. Second, validity of VREM against CAFM (gold standard) and test-retest reliability of VREM were analyzed, using kappa index and the intraclass correlation coefficient (ICC). RESULTS: 6 items were included in the VREM: Walking, Gardening, Sport/dancing, Climbing stairs, Shopping walking and Cleaning house. The interview using VREM lasted 5 minutes (standard deviation 2). Agreement between both questionnaires, using 4 levels of physical activity, was 95.5% (kappa=0.93). Test-retest reliability of the questionnaire was 92.5% (kappa=0.88). Using a continuous outcome in metabolic energy turnover (MET), VREM also proved to be valid and reliable (ICC=0.95 and ICC=0.96 respectively). CONCLUSION: This short version of CAFM has shown good validity and reliability in people ≥50 years.

Validación de una versión reducida en español del Cuestionario de Actividad Física en el tiempo libre de Minnesota (VREM) / Validation of a Spanish Short Version of the Minnesota Leisure Time Physical Activity Questionnaire (VREM)

Fundamentos: con el fin de disponer de una versión breve y en españoldel Cuestionario de Actividad Física en el tiempo libre de Minnesota (CAFM) para poder utilizarlo en atención primaria, el objetivo de este trabajo es presentar la elaboración de la versión reducida (VREM) y su validación. Métodos: Estudio descriptivo de validación del cuestionario, realizada en cinco centros de Atención Primaria de Barcelona. Se seleccionaron 200 sujetos igual o mayores de 50 años que consultaron por cualquier motivo, con una distribución por edad y sexo similar a la de la población de Cataluña . Dos fases: primera, se construyó el VREM mediante reducción del número de ítems. Segunda, se evaluó su validez de criterio respecto al CAFM (referencia) y la fiabilidad test-retest mediante el índice kappa y el coeficiente de correlación intraclase (CCI). Resultados: Los 6 ítems incluidos en el VREM fueron: caminar, trabajar el huerto, hacer deporte o bailar, subir escaleras, ir a comprar a pie y limpiar la casa. La duración de la entrevista mediante el VREM fue de 5 minutos (desviación estándar 2). La validez de criterio entre ambos cuestionarios, usando 4 categorías de actividad física, fue del 95,5% (kappa=0,93). La fiabilidad test-retest del cuestionario fue del 92,5% (kappa=0,88). Usando un resultado continuo en forma de metabolic energy turnover (MET) el VREM también mostró una alta validez y fiabilidad (CCI=0,95 y CCI=0,96 respectivamente). Conclusiones: La versión reducida del CAFM es válida y fiable en población mayor o igual a 50 años(AU)

Background: The aim of this study is to develop and validate a shorter version (VREM) of the Spanish version of theMinnesota leisure time PhysicalActivity Questionnaire (CAFM), in order to have a shorter physical activity questionnaire to be used in Primary Care. Methods: Descriptive study of validation of a new physical activity measurement questionnaire. 200 patients older than 50, who visited one of 5 primary care centers in Barcelona for any reason were selected, with age-sex Catalonia’s distribution. Two phases: first, VREM construction through items reduction. Second, validity of VREM against CAFM (gold standard) and test-retest reliability of VREMwere analyzed, using kappa index and the intraclass correlation coefficient (ICC). Results: 6 items were included in the VREM:Walking, Gardening, Sport/dancing, Climbing stairs, Shopping walking and Cleaning house. The interview using VREM lasted 5 minutes (standard deviation 2). Agreement between both questionnaires, using 4 levels of physical activity, was 95.5% (kappa=0.93). Test-retest reliability of the questionnaire was 92.5% (kappa=0.88). Using a continuous outcome in metabolic energy turnover (MET), VREM also proved to be valid and reliable (ICC=0.95 and ICC=0.96 respectively). Conclusion: This short version of CAFM has shown good validity and reliability in people >=50 years(AU)

Relación entre actividad física en el tiempo libre y el índice tobillo-brazo en población general española: estudio ARTPER / The relationship between physical activity in leasure time and the ankle-brachial index in a general Spanish population: The ARTPER study

Fundamento y objetivo: Niveles elevados de actividad física durante la vida diaria se asocian con un menor deterioro funcional en las personas con arteriopatía periférica (AP) y positivamente con el índice tobillo-brazo (ITB) en sujetos libres de esta enfermedad. El objetivo de este estudio es examinar la relación entre la actividad física en el tiempo libre (AFTL) y el ITB en población general. Material y método: Se analizaron los datos basales de la cohorte ARTPER correspondientes a 2.840 sujetos mayores de 49 años de Barcelona. La AFTL se obtuvo mediante la versión reducida validada en español del Cuestionario de actividad física en el tiempo libre de Minnesota. Se consideró AP un ITB < 0,9. Para evaluar la asociación independiente entre AFTL y AP se utilizaron modelos de regresión logística multivariante. Resultados: Los sujetos que realizaban más AFTL eran más jóvenes, mujeres, menos fumadores y tenían menos AP. La actividad total medida en metabolic energy turnover (MET) y el cómputo de horas totales de AFTL fue significativamente superior en sujetos sanos (p < 0,001). Existía una relación inversa entre la AFTL total y el riesgo de padecer AP (odds ratio 0,56, intervalo de confianza del 95% 0,38-0,81 para los que gastaban 2.700 o más MET en 14 días) ajustando por factores de confusión. Conclusiones: La AFTL se relacionó positivamente con el ITB en nuestro estudio, siendo los sujetos con AP los que menos AFTL realizaban (AU)

Background and objective: High levels of daily physical activity have been shown to be linked to decreased functional impairment in peripheral artery disease (PAD) patients and positively related to the ankle brachial index (ABI) in subjects without PAD. The aim of this study was to examine the relationship between leisure time physical activity (LTPA) and the ABI in a general population. Material and method: Baseline data from the ARTPER study cohort corresponding to 2,840 subjects > 49 years from Barcelona were analyzed. The LTPA variable was obtained through the validated Spanish short version of the Minnesota Leisure Time Physical Activity Questionnaire. ABI < 0.9 was taken to indicate PAD. Multivariate logistic regression analysis was performed to evaluate the independent association between LTPA and PAD. Results: Subjects with more LTPA were younger, female, less smokers, and suffered fewer PAD. Total activity, measured in metabolic energy turnover (MET) and the LTPA hours, was significantly higher in subjects without PAD (P < .001). There was an inverse relationship between LTPA and the risk of suffering PAD (odds ratio 0.56, 95% confidence interval 0.38-0.81 for those who expended 2,700 METs or more in 14 days) adjusting for confounding factors. Conclusions: In our study, LTPA was positively related to the ABI, with those with PAD being the ones with less LTPA (AU)

¿A quién medir el índice tobillo-brazo? / Who should have the ankle-arm index measured?

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Infradiagnóstico de la arteriopatía periférica en la población española. Estudio ARTPER / Underdiagnosis of peripheral arterial disease in the spanish population. ARTPER study

Fundamento y objetivo: Aunque la arteriopatía periférica (AP) es un importante marcador de morbimortalidad cardiovascular, desconocemos cuántos pacientes están infradiagnosticados. El objetivo es conocer el infradiagnóstico de la AP y estudiar los factores asociados.Pacientes y método: Se estudió a 3.786 pacientes mayores de 49 años, seleccionados aleatorizadamente. Se definió AP si el índice tobillo-brazo (ITB) era inferior a 0,9. Se consideró infradiagnóstico si era inferior a 0,9 y no estaban diagnosticados de AP en la historia clínica, se determinó también la presencia de claudicación intermitente (CI) mediante el cuestionario de Edinburgh. Resultados: El 7,6% tenía un ITB inferior a 0,9 (intervalo de confianza [IC] del 95% de 6,7–8,4). De estos pacientes, estaba infradiagnosticado el 80,7%, a pesar de que el 29,3% presentaba clínica de CI. El infradiagnóstico fue inferior en fumadores o ex fumadores (odds ratio [OR] de 0,20; IC del 95% de 0,07–0,59), si existía CI (OR de 0,40; IC del 95% de 0,18–0,89), si el ITB estaba entre menos de 0,7 y 0,5 o más (OR de 0,36; IC del 95% de 0,16–0,81) o si era inferior a 0,5 (OR de 0,04; IC del 95% de 0,01–0,20); fue superior en los pacientes de 70 años de edad o más (OR de 3,12; IC del 95% de 1,12–8,67). Conclusiones: El infradiagnóstico de AP es elevado, especialmente en los pacientes de edad avanzada. Es necesario consensuar criterios para la práctica del ITB en la población general (AU)

Background and objectives: Although peripheral arterial disease (PA) is an important clinical marker of cardiovascular morbimortality, the rate of under-diagnosis is unknown. Our aimed to know the proportion of patients underdiagnosed of PA and the associated factors. Patients and methods: 3786 patients >49 years old, randomly selected, were studied. PA was diagnosed by means of the ankle-brachial index (ABI<0, 9). Underdiagnosed was considered when ABI<0,9 and when they were not diagnosed of PA in the clinical record. We also determined the presence of intermittent claudication (IC) defined by Edinburgh's questionnaire.Results: 7,6% had an ABI <0, 9 (IC95% 6,7–8, 4). Of these patients 80.7%, were underdiagnosed, although the 29,3% had IC. PA underdiagnosis was low in current smokers or former smokers (OR 0.20; IC95% 0,07–0,59), if IC (OR 0.40; IC95% 0,18–0,89), if ABI between <0.7 and 0.5 (OR 0.36; IC95% 0,16–0,81) or <0,5 (OR 0,04; IC95 % 0,01–0,20), being higher in >70 years (OR 3,12; IC95% 1,12–8,67). Conclusions: PA underdiagnosis is high, especially in old patients. It is necessary to reach consensus criteria for the practice of the ABI in the general population (AU)