The Paradox of Exercise Intensity in Preventing Cardiovascular Events in Peripheral Arterial Occlusive Disease

Peripheral arterial disease (PAD) is characterized by narrowing of the arteries of the lower limbs due to atherosclerotic involvement. Its clinical manifestations go far beyond just a reduction in blood flow, leading to chronic ischemia. Current evidence shows that endothelial dysfunction, oxidative stress, arterial stiffness and inflammation also lead to functional impairment, consequently to patient decline.

All these factors end up impacting the quality of life of individuals, as it reduces their walking resistance, with intermittent claudication (IC) as the main symptom. Last but not least, we have also found progressive damage to muscle fibers caused by this chronic ischemia, further worsening the dysfunction of the skeletal muscle and metabolic morphology of the limb. This ends up creating an important barrier to the practice of physical activity, perpetuating and increasing the risk of cardiovascular events.^–

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