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Intermittent claudication and subsequent cardiovascular disease in the elderly

E M Simonsick1, J M Guralnik, C H Hennekens

  • 1Epidemiology, Demography, and Biometry Program, National Institute on Aging, Bethesda, Maryland.

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|January 1, 1995
PubMed
Summary

Intermittent claudication (IC) is common in older adults and predicts higher mortality and cardiovascular events. Measuring IC improves risk prediction for cardiovascular morbidity and mortality in this population.

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Area of Science:

  • Gerontology
  • Epidemiology
  • Cardiovascular Medicine

Background:

  • Prevalence of intermittent claudication (IC) in community-dwelling older adults (≥65 years).
  • Comparison of cardiovascular risk factors and comorbidities in individuals with and without IC.
  • Examination of IC's independent association with mortality, myocardial infarction, stroke, and disability.

Purpose of the Study:

  • To determine the prevalence of IC in older adults.
  • To compare risk factors and comorbidities between those with and without IC.
  • To assess IC's predictive value for mortality and cardiovascular events.

Main Methods:

  • Pooled data from 8996 older adults from the Established Populations for Epidemiologic Studies of the Elderly (EPESE) sites.

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  • Data collected between 1982 and 1988.
  • Analysis of self-reported IC and its association with health outcomes.

    • Main Results:

    • IC prevalence was 2.4% in men and 1.5% in women.
    • Individuals with IC showed higher rates of diabetes, cardiovascular comorbidity, and smoking.
    • IC independently predicted increased mortality, myocardial infarction, stroke, and disability.
    • IC doubled the risk of cardiovascular mortality in those with prior angina, myocardial infarction, or stroke.

    Conclusions:

    • Intermittent claudication is a significant independent predictor of mortality and cardiovascular morbidity in ambulatory older adults.
    • IC's predictive power for cardiovascular morbidity and mortality is enhanced when considered alongside traditional risk factors and existing coronary ischemia.
    • Measuring IC can improve the prediction of adverse cardiovascular outcomes in the elderly population.