On entry and after 12 weeks, calf blood flow was
On entry and after 12 weeks, calf blood flow was
measured in the leg with the most severe arterial
disease (lowest resting ankle-to-arm blood pressure
ratio) using venous occlusion plethysmography as
previously described.32 Subjects were studied in the
supine position with the calf elevated and the foot
strapped to a pedal. Calf exercise was performed by
repeatedly flexing the ankle against a 10 lb weight
(3-W work load), 1 Hz, until maximal symptoms of
claudication pain occurred. Immediately after exercise,
an ankle cuff was inflated to 200 mm Hg, and
then a thigh cuff was inflated to 40 mm Hg for the
first measurement of calf blood flow. A second
measurement of calf blood flow was obtained within
10 seconds after exercise, and these two flow measurements were averaged to provide an estimate of meaimmediate
postexercise hyperemic flow. Flow measurements
were not obtained in one treated subject
because of technical problems.
Finally, at entry and after 12 weeks, patients were
asked to characterize their claudication-limited walking
distance (in blocks) and speed (the difficulty in
walking one block quickly, average speed, or slowly)
in the community setting.