A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD). Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with PAD published in JAMA showed that regular six–minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six–minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet. There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it. Such exercise leads to improvement in “collateral circulation” growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program. Walking is a standard recommendation for people with PAD. A recommended regimen is a 40–minute walk three times a week for at least six months. Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm.

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