Intermittent claudication prevalence

Hughson WG, Mann JI, Garrod A. Intermittent claudication. Prevalence and risk factors. Brit Med J 1978 1 137. 

More than 5 million (estimated range 4 to 7 million) adults age 40 years or more have PAD and 95% of individuals with PAD have at least one cardiovascular risk factor the majority of patients have multiple risk factors for CVD. Based on the PAD Awareness, Risk, and Treatment New Resources for Survival (PARTNERS) program, the prevalence of PAD in primary care practices is high, yet physician awareness of the PAD diagnosis is relatively low. In this cross-sectional study, PAD was detected in 29% of 6979 patients and 83% of the patients were aware of their diagnosis but only 49% of their patients physicians were aware. The reason for this observation is that patient self-report of symptoms and the use of questionnaires to detect PAD are not sufficiently sensitive and specific to reproducibly diagnosis PAD and the cardinal symptom of PAD, intermittent claudication, is present in the minority of patients (1 to 27%). A simple ABI measurement wiU identify a large number of patients with previously... 

Stevenow L, Karlsson S, Lilia B, Lindgarde F. High prevalence of coronary heart disease in patients with intermittent claudication. Acta Chir Scand 1988 154 447-451. 

Several prospective randomized trials have reported that cilostazol improves walking distance in patients with intermittent claudication by 40 to 50%, compared to placebo after 12 to 24 weeks of treatment (20,21). One of these placebo-controlled trials evaluated both pentoxifylline and cilostazol (17). Pentoxifylline demonstrated no benefit in either onset of claudication or absolute claudication distance as compared to placebo. Cilostazol, however, significantly improved both distances compared to placebo (17). A prevalent side effect of cilostazol is headache. Transient diarrhea, palpitations, and dizziness have also been reported. The FDA has issued a warning regarding the use of cilostazol in patients with congestive heart failure, because of the increased possibility of sudden cardiac death observed with other forms of diesterase type III inhibitors. Thus, it has become routine practice to assess cardiac function clinically and echocardiographically prior to initiating therapy with cilostazol for claudication, and periodically thereafter. As a result of the modest vasodilatation, heart rate may increase by a mean of 5.1 and 7.4 beats per... 

Ingolfsson LO, Sigurdsson G, Sigvaldoson H, et al. A marked decline in the prevalence and incidence of intermittent claudication in Icelandic Men. 1968-1986 A strong relationship to smoking and serum cholesterol. The Reykjavik Study. J Clin Epidemiol 1994 47 1237-1243. 

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