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  1. Pieper, Barbara PhD, RN, APCNS-BC, CWOCN, FAAN
  2. Kirsner, Robert S. MD, PhD
  3. Templin, Thomas N. PhD
  4. Birk, Thomas J. PhD, MPT, FACSM


OBJECTIVE: Examine the occurrence of and risk factors for peripheral arterial disease (PAD) in a sample in drug treatment.


DESIGN: Cross-sectional/stratified design.


SETTING: Ten methadone treatment centers in a large Midwestern metropolitan area in the United States.


PARTICIPANTS: Six hundred forty participants (290 men [45.3%]; mean [SD] age, 46.54 years [8.85 years]) were included in the study. Sixty-one percent were African American, and 93.5% had a history of smoking cigarettes.


MAIN OUTCOME MEASURES: PAD was defined as an ankle brachial index of less than 0.90 in at least 1 leg. Measures included demographic, health, and illicit drug use history questionnaires; the Walking Impairment Questionnaire; and body mass index. The Positive Attitude Toward Physical Activities/Exertion Questionnaire was added 9 months into the study; this decreased the sample size of the logistic regression for the predictors of PAD to 498.


MAIN RESULTS: PAD was identified in 16.7% of the sample; the mean ankle brachial index value for persons with PAD was 0.84 (SD, 0.05). Multiple logistic regression analysis found that sex (women) (odds ratio [OR], 2.10), history of ever smoking cigarettes (OR, 5.16), years of smoking cigarettes (OR, 1.60 per 10 years' smoking), and having a positive attitude toward physical activities/exertion (OR, 0.63) made significant contributions to the predictors for PAD after controlling other background and risk variables.


CONCLUSION: PAD is prevalent in persons undergoing drug treatment and is best accounted for by cigarette smoking, sex differences, and physical inactivity. PAD in drug abusers should be evaluated, and the current findings merit further investigation.