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[Intermittent claudication--a major cardiovascular risk factor. Proposed guidelines for investigation and treatment]
P Svensson1, E Wahlberg, U Hedin
1Kliniken för akut och kardiovaskulär medicin, Karolinska sjukhuset, Stockholm. persv@divmed.ks.se
Insights
Intermittent claudication, a common condition, is diagnosed through history and physical exam. Treatment focuses on lifestyle changes, risk factor management, and aspirin to reduce cardiovascular disease risk.
Area of Science:
- Vascular Medicine
- Cardiology
- Public Health
Context:
- Intermittent claudication (IC) is a prevalent symptom of peripheral artery disease (PAD).
- Diagnosis is typically clinical, relying on patient history and physical examination.
- IC patients represent a high-risk group for cardiovascular events.
Purpose:
- To outline the diagnostic approach to intermittent claudication.
- To detail evidence-based treatment strategies for IC.
- To emphasize the importance of cardiovascular risk factor modification in IC patients.
Summary:
- Intermittent claudication diagnosis relies primarily on clinical assessment.
- Management includes smoking cessation, increased walking, risk factor control (hypertension, hyperlipidemia, diabetes), and aspirin.
- Advanced diagnostics like duplex ultrasonography are reserved for diagnostic uncertainty or surgical planning.
Impact:
- Improved patient outcomes through targeted risk factor management.
- Reduced cardiovascular morbidity and mortality in the IC population.
- Optimized use of diagnostic resources, reserving advanced imaging for specific indications.
Abstract:
Intermittent claudication is a common disorder, the diagnosis of which can usually be made on the basis of careful history taking and physical examination. Treatment should be focused on abstinence from smoking, increased daily walking distance, risk-factor modification, and aspirin prophylaxis. Laboratory studies including duplex ultrasonography should be limited to cases where uncertainty exists or to the preoperative work-up for invasive intervention. Intermittent claudication patients merit special attention as a category at high risk of cardiovascular disease, and in whom risk factors such as hypertension, hyperlipidaemia and diabetes need to be identified and treated.