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Thermotherapy Reduces Blood Pressure and Increases Leg Blood Flow in Patients With Symptomatic Peripheral Artery Disease
Author(s) -
Roseguini Bruno Tesini,
Neff Dustin,
Kuhlenhoelter Alisha,
Wong Brett,
Motaganahalli Raghu
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1290.10
Subject(s) - medicine , blood pressure , blood flow , intermittent claudication , claudication , peripheral , cardiology , popliteal artery , coronary artery disease , arterial disease , artery , femoral artery , surgery , vascular disease
Peripheral arterial disease (PAD) is characterized by atherosclerotic obstruction of the arteries in the lower extremities and affects approximately 10% of individuals older than 65 years. The most common clinical presentation of PAD is intermittent claudication (IC), defined as leg pain caused by insufficient blood flow during walking. Despite the increasing prevalence of this condition, few non‐invasive therapies exist to improve vascular function and exercise tolerance in patients with IC. Recent studies demonstrated that repeated exposure to thermotherapy (TT) alleviates the symptoms of the disease, but the mechanisms by which TT exerts its clinical benefits remain elusive. We tested the hypothesis that application of leg thermotherapy (TT) using a water‐circulating garment system would increase leg blood flow and reduce blood pressure in patients with IC. Fourteen patients (age: 63±9 yrs) completed two experimental sessions, at least 72 hrs apart, in a randomized, cross‐over design. In the TT session, water at 48°C was circulated through the garment for 90 min, while thermoneutral water (33°C) was used in the control intervention. Leg skin temperature, core body temperature, heart rate and blood pressure were measured before, during and for 2 hrs following the interventions. A subset of 7 patients also underwent a protocol for the measurement of blood flow in the popliteal artery before and during 90 min of TT using phase contrast magnetic resonance imaging. Application of TT for 90 min induced marked increases from baseline in leg skin temperature (from 32.9±0.3 to 39.8±0.5°C, p<0.01) and HR (from 64±3 to 76±4 bpm, p<0.01) as well as a modest increase in core temperature (from 36.9±0.1 to 37.5±0.2°C, p<0.01). Compared to the control intervention, TT promoted a sustained reduction in systolic (~14 mmHg) and diastolic (~6 mmHg) blood pressure (p<0.05). In addition, TT application induced a marked increase in peak blood flow velocity (~92%), average velocity (~81%), and average blood flow per min (~97%) in the popliteal artery (p<0.01). These findings indicate that TT is a simple and effective strategy to reduce blood pressure and enhance leg blood flow in patients with IC. Support or Funding Information Indiana Clinical and Translational Science Institute Project Development Team