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Update on some epidemiologic features of intermittent claudication: the Framingham Study
Journal of the American Geriatrics Society
|January 1, 1985
Summary
Peripheral arterial disease (PAD), causing intermittent claudication (IC), affects men more than women and increases with age. Key risk factors include smoking, hypertension, and impaired glucose tolerance, with higher risk in women. Mortality risk is significantly elevated.
Area of Science:
- Cardiovascular Epidemiology
- Vascular Medicine
Background:
- Occlusive peripheral arterial disease (PAD) leading to intermittent claudication (IC) is a significant health concern.
- Long-term epidemiological data are crucial for understanding PAD incidence and risk factors.
Purpose of the Study:
- To analyze the incidence and risk factors of intermittent claudication (IC) in a large cohort over 26 years.
- To compare the risk profile of IC with coronary heart disease and assess its impact on mortality.
Main Methods:
- Prospective surveillance of 5,209 subjects in the Framingham Heart Study cohort over 26 years.
- Analysis of incidence rates, demographic factors, lifestyle choices (smoking, glucose tolerance), and clinical measurements (hypertension, vital capacity, ECG, cholesterol, weight, hematocrit).
Main Results:
- 176 men and 119 women developed IC, with incidence rising sharply with age until 75 and a twofold male predominance.
- Significant risk factors included cigarette smoking (doubling risk), hypertension (2.5-4 fold increase), impaired glucose tolerance (greater in women), low vital capacity, and left ventricular hypertrophy.
- Serum cholesterol, relative weight, and hematocrit were weak predictors; a risk profile for IC was more predictive than for coronary heart disease.
- Mortality was increased two- to fourfold, primarily due to cardiovascular disease.
Conclusions:
- Intermittent claudication (IC) incidence and risk factors are well-defined, with distinct patterns in men and women.
- Major cardiovascular risk factors significantly predict IC, offering a basis for targeted prevention strategies.
- PAD significantly increases overall mortality, underscoring the need for early detection and management.