Supervised exercise markedly improves walking ability in patients with leg artery blockages

American Heart Association Late-Breaking Clinical Trial Report - Abstract: 18642 - EMBARGOED UNTIL 8AM ET November 16, 2011 Study Highlights:Supervised exercise, when added to home walking and treatment with cilostazol, significantly improved walking ability among patients with blocked blood vessels to the legs (peripheral artery disease),This approach was more effective for increasing leg function and quality of life than adding stent placement to home walking and cilostazol.Cilostazol is used to treat people with peripheral artery disease who have leg pain with exercise. The medicine improves blood flow to the legs.ORLANDO, FLA., Nov. 16, 2011 — In patients on standard therapy for blocked leg vessels, adding a supervised treadmill exercise program improved walking ability significantly better than stenting, according to late-breaking research presented at the American Heart Association’s Scientific Sessions 2011. Patients on either additional therapy improved walking ability better than standard therapy alone, which is home walking and cilostazol, a medicine that improves blood flow to the legs. The study, called CLaudication: Exercise Vs Endoluminal Revascularization Study (CLEVER), is also published in Circulation: Journal of the American Heart Association.About 9 million people in the United States have clogged blood vessels to the legs, or peripheral artery disease (PAD). More than 2 million of these patients suffer from leg muscle pain with exercise. This symptom, called claudication, can severely limit mobility. Patients and physicians have treated claudication with either supervised exercise, medications, or angioplasty and stent placement. Until now, however, the relative effectiveness of each type of treatment was unclear. The use of stents has increased, and exercise is not often used. Investigators randomized patients to home walking plus cilostazol or to the same approach plus one of two other interventions: supervised treadmill exercise or placement of a stent to reduce narrowing in the iliac artery, a large blood vessel supplying blood to the leg. Stents are most effective for PAD when used at this anatomic site.Six months after study enrollment, patients in the supervised exercise program significantly increased their treadmill walking time, as did those who received stents. In contrast, patients who only exercised at home showed little improvement. The average walking time in each group improved by: 5.8 minutes