Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INTERMITTENT CLAUDICATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,693 records · Page 94Linked to original sources
PubMed2005

Ankle-brachial index and peripheral arterial disease.

Patients with peripheral arterial disease including those with intermittent claudication have a high risk for cardiovascular and cerebrovascular morbidity and mortality. The outcome of patients with intermittent claudication is less limited by local complications in the leg than by the systemic complications of coronary and cerebral vessels. About 30 % of these patients will die within 5 years, three-quarters of them due to vascular events. Analyses using data of the KORA Study 2004/2005 (F3), a follow-up examination of the participants of the MONICA Survey 1994/95 (S3), will try to identify biochemical as well as genetic risk factors for peripheral arterial disease. The anti-atherogenic apolipoprotein A-IV will be one of our candidates of interest.

Adult↗
PubMedDate not supplied

Drug treatment of peripheral vascular disease.

There are a limited number of clinically effective pharmacotherapeutic agents for treatment of peripheral vascular disorders. Pentoxifylline and cilostazol are available for the symptomatic treatment of intermittent claudication. Analogs of carnitine and L-arginine are being evaluated for treatment of the symptoms of intermittent claudication, and prostaglandins and growth factors are being evaluated for critical limb ischemia. Calcium channel blockers remain the treatment of choice for Raynaud's phenomenon. Alternative vasodilators may be used selectively to treat individuals with Raynaud's phenomenon who are intolerant of calcium channel blockers or in whom such therapy has been unsuccessful. Prostaglandins have been evaluated in patients with refractory Raynaud's phenomenon who also have digital ulceration. The mainstay of short-term treatment (and prophylaxis) of deep vein thrombosis (DVT) has been unfractionated heparin, but now the use of low molecular weight heparin (LMWH) has emerged. Newer agents, such as heparinoids and direct thrombin inhibitors, hold promise for the prevention and treatment of DVT. Prolonged treatment with warfarin is still required to prevent recurrent thrombosis, although the duration of treatment has come under debate.

Arteriosclerosis Obliterans↗
PubMed1988

Effects of venesection on leg blood flow in claudicants with high-normal haematocrit.

Patients with intermittent claudication frequently have high-normal levels of haematocrit and hence blood viscosity, which may contribute to decreased calf blood flow on exercise, and hence to the symptom of claudication. Reduction in haematocrit and viscosity by serial venesection in eight patients with stable claudication and high-normal haematocrit (mean 0.50) was performed, and the effects on claudication, calf blood flow, and calf oxygen delivery were studied. Following reduction in haematocrit to low-normal levels (mean 0.44), resting calf blood flow was unchanged; peak flow after ischaemic exercise increased slightly (+17%), but peak oxygen delivery (peak flow X haemoglobin concentration) was unchanged. Hence any increase in calf blood flow in the symptomatic leg is balanced by a decrease in oxygen-carrying capacity after venesection. No increase in claudication time would therefore be expected, and none was observed in the present study.

Adult↗
PubMed2004

Predictors of cognitive decline and mortality of aged people over a 10-year period.

BACKGROUND: The search for preventable and remediable risk conditions of cognitive decline is ongoing, but results have thus far been inconsistent. According to the hypothesis of our 10-year prospective study, the predictive values of different risk indicators change over time in a general 75+ population. METHODS: A population-based sample of 75-, 80-, and 85-year-old individuals (n=650) underwent comprehensive clinical examinations in 1990 in Helsinki, Finland. Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and/or Clinical Dementia Rating (CDR) at baseline and after 1, 5, and 10 years. RESULTS: At baseline, a low MMSE score was associated with age, history of stroke, apolipoprotein E allele epsilon4 (APOE4), and intermittent claudication. After 1 year, cognitive decline was typical of participants suffering from vascular diseases, e.g., heart failure and intermittent claudication. Five-year decline was predicted by the presence of atrial fibrillation (RR [relative risk] 2.8), APOE4 (RR 2.4), elevated C-reactive protein (CRP) (RR 2.3), diabetes mellitus (RR 2.2), and heart failure (RR 1.8). They also tended to increase 5-year all-cause mortality. At 10 years, the decline associated with APOE4 (RR 3.3), slightly elevated serum ionized calcium (RR 3.3), and feelings of loneliness (RR 3.0). CONCLUSIONS: Long follow-up of a general aged population explains several inconsistencies of earlier reports. In 75+ individuals, general ill health is a strong associate of cognitive deficits. The strongest predictors of both cognitive decline and mortality are age, APOE4, manifest vascular diseases, and diabetes. The role of new potential predictors, feelings of loneliness and hypercalcemia, needs clinical testing.

Aged↗
PubMed1991

The fate of the claudicant--a prospective study of 1969 claudicants.

A prospective study of 1969 patients with intermittent claudication receiving placebo medication for a minimum of 1 year is reported. Patients were carefully monitored and only four patients were lost to follow-up. Annual mortality was 4.3%. Thirty-six patients developed a definite myocardial infarction, 27 a major stroke, 32 required a major amputation and 111 required surgical or radiological intervention for deteriorating ischaemia of the leg. The entry characteristics of the patients were analysed as a predictor of serious cardiovascular events. The most sensitive predictors of total mortality were age, history of coronary heart disease and an ankle/arm pressure ratio below 0.5. Of the laboratory measurements performed only the initial white cell count was a significant predictor of myocardial infarction, stroke and vascular deaths.

Amputation, Surgical↗
PubMedDate not supplied

Serum HDL/total cholesterol ratio and blood pressure in asymptomatic atherosclerotic lesions of the cervical carotid arteries in men.

One hundred neurologically asymptomatic male subjects (aged 50-69 years), randomly selected through population registers, were screened for atherosclerotic lesions of the cervical carotid arteries, using a high resolution multi-gate pulsed Doppler system. In 93 subjects serum was assayed for total and HDL cholesterol. Besides, cuff arterial blood pressure measurements were made. Twenty-three of these subjects (Group III) were classified as abnormal according to the Doppler investigation (degree of narrowing less than 50% in 78% of the cases). Seven of these 23 subjects also had a history of ischemic heart disease or intermittent claudication. Of the 70 subjects with a normal Doppler examination 16 had a history of ischemic heart disease and/or intermittent claudication (Group II). The remaining 54 subjects served as controls (Group I). The frequency of asymptomatic atherosclerotic lesions of the cervical carotid arteries in the population under investigation was 23%. The HDL/total cholesterol ratio was lower and the frequency of high blood pressure higher in the Groups II and III than in Group I. The findings in this study support the idea that a low serum HDL/total cholesterol ratio and high blood pressure have a high degree of association with atherosclerotic lesions of the cervical carotid arteries. This association is already apparent at an early stage of the disease, i.e. in asymptomatic subjects with a slight to moderate degree of carotid artery narrowing.

Aged↗
PubMed1975

Characteristics of smokers, nonsmokers and ex-smokers among 10,000 adult males in Israel. I. Distribution of selected sociodemographic and behavioral variables and the prevalence of disease.

Sociodemographic and behavioral characteristics of nonsmokers and smokers were compared in a large sample of working men aged 40 to 65 years. The prevalence of several diseases was compared. There was a significantly higher percentage of smokers among those born in the Middle East (outside Israel) and North Africa. Smokers were characterized by crowded housing (a high number of persons per room); low levels of education; little leisure-time physical activity; and a tendency to be nonreligious. Current cigarette smoking gradually decreased with age, while smoking a cigar or pipe only, increased. The demographic and behavioral profile of current smokers in general, and of "heavy" (larger than or equal to 21 cigarettes/day) smokers in particular, resembled that of those who had smoked at any time. Both the current and the "heavy" smokers were more often later immigrants to Israel, had more children, and were physically active at work, frequently being engaged in manual labor or technical work. Prevalence of myocardial infarction, angina pectoris, definite peripheral arterial disease, intermittent claudication and peptic ulcer was significantly higher among those who had smoked at any time. Apart from silent myocardial infarction and intermittent claudication, subjects with these conditions also included a significantly higher percentage of former smokers. Former smoking was also related to age, number of years in the country, less crowding at home, low activity at work, and a low calorie intake (particularly of protein and carbohydrates).

Activities of Daily Living↗
PubMed1993

Asymptomatic carotid artery bifurcation disease in patients with claudication.

A study was undertaken to determine the prevalence of asymptomatic atherosclerotic carotid artery bifurcation disease in patients presenting with claudication; thus 263 consecutive patients with intermittent claudication, but without recent or old cerebrovascular symptoms were studied by routine carotid duplex scanning. Of the 263 patients, 124 (47.1%) had a C, D, D+ or E lesion in some vessels of the carotid bifurcation and 54 (20.5%) had a D, D+ or E lesion of the common or internal carotid arteries. Women had a higher prevalence of significant carotid stenosis (29.6% v. 18.2% in men) as did patients over the age of 70 years (28.6% v. 16.3% if below 70 years). It is concluded that the prevalence of clinically significant carotid bifurcation disease (greater than 50% stenosis in the common or internal carotid arteries) in patients with claudication is high (20.5%). The presence of an asymptomatic high-grade stenosis (D+ or E) in 11.8% of patients with claudication should alert the clinician that he is treating a patient who is at a high risk of developing cerebrovascular ischaemic complications.

Aged↗
PubMed2004

Near-infrared spectroscopy with treadmill exercise to assess lower limb ischemia in patients with atherosclerotic occlusive disease.

PURPOSE: We used near-infrared spectroscopy (NIRS) to measure exercise-induced ischemia in patients with intermittent claudication, and compared these results with those obtained by ankle-brachial pressure index (ABPI) analysis. METHODS: Sixty-two patients with intermittent claudication caused by atherosclerotic occlusive disease exercised on a treadmill until reaching the maximal tolerated walking distance. We measured the ABPI at rest and after exercise until it returned to the baseline value. A NIRS probe was positioned on the patient's calf, which allowed the continuous monitoring of oxygen saturation (StO2), oxygenated hemoglobin (Oxy Hb), and deoxygenated hemoglobin (Deoxy Hb) in the calf muscles before, during, and after exercise. During exercise, the StO2 and Oxy Hb decreased, and the Deoxy Hb increased. The time taken for each measurement to return to the baseline value was defined as the recovery time. The recovery times obtained by NIRS and ABPI were compared. RESULTS: The recovery time for ABPI correlated well with that for StO(2 (rhos = 0.73), Oxy Hb (rhos = 0.63), and Deoxy Hb (rhos = 0.65); however, the recovery times measured by NIRS were shorter than the recovery time for the ABPI. CONCLUSIONS: Near-infrared spectroscopy is a reliable method for monitoring peripheral circulation during and after exercise, although the data generated provided slightly different information than the results obtained by ABPI.

Adult↗
PubMedDate not supplied

Effect of pentoxifylline on Wrb antigen.

Pentoxifylline, a hemorrheologic agent that lowers whole blood viscosity by increasing red cell membrane deformability, recently was approved by the Food and Drug Administration for the treatment of intermittent claudication. The effect of this drug on the phenotypic expression of red cell blood group antigens was studied with cells collected from six patients with intermittent claudication. After in vivo treatment with pentoxifylline, the serologic expression of the Wrb antigen increased. Comparative studies, using hemagglutination titration techniques, with red cells collected before treatment and 1 month after treatment, showed an increase in titer of at least two tubes and an increase in score of greater than 10 in all six patient samples drawn after treatment. No in vivo serologic changes were observed in any of the other antigens studied (A, B, D, C, E, c, e, M, N, S, s, U, P1, Leb, K, k, Fya, Fyb, Jka, Jkb, Yta). Protein analysis (sodium-dodecylsulfate polyacrylamide gel electrophoresis, silver stain) of red cell membranes prepared from blood collected before treatment and 1 month after treatment showed an increase in band density in the 24,000 and 14,000 dalton regions in the samples drawn after treatment. In vitro treatment of red cells with pentoxifylline and one of its major metabolites did not affect the phenotypic expression of any of the antigens studied, including Wrb.

Blood Group Antigens↗
PubMed2000

Popliteal amyloidoma presenting with leg ischemia in a chronic dialysis patient.

The authors report a case of bilateral popliteal amyloidoma causing stenosis of the popliteal artery and vein. This patient had been treated with hemodialysis for 26 years. The diagnosis was made with MR angiography. A popliteal tumor of the right knee was resected surgically and the histologic examination showed deposition of amyloid. After resecting the popliteal tumor, the severe leg pain and intermittent claudication improved. This report suggests that popliteal amyloid tumors should be considered in a patient undergoing long-term hemodialysis who complains of leg pain and intermittent claudication.

Adult↗
PubMed2004

[Prevalence of abdominal aortic aneurysm and peripheral arterial diseases in ambulatory patients with coronary disease].

Presence of peripheral arterial disease in patients with coronary artery disease is associated with worse outcome. The aim of this epidemiological study was to evaluate the prevalence of different manifestation of atherothrombosis and its risk factors in the group of 2969 ambulatory patients with coronary artery disease. Mean age of investigated group was 61.2 +/- 10.5 years and 64% patients were male. Abdominal aortic aneurysm was diagnosed in 1.2% of patients, intermittent claudication in 13%, carotid stenosis in 5%. History of stroke was given in 4.4% cases and history of TIA in 7%. Only in 8% of patients with intermittent claudication ankle-brachial index was assessed. We conclude that among patients with coronary artery disease other arteries atherothrombotic involvement is diagnosed in our country infrequently and efforts to recognize other symptoms of atherothrombosis should be encouraged.

Aged↗
PubMed1998

[Quality of life and peripheral obliterative arteriopathy. Perspective for the future].

Atherosclerosis is the primary cause of peripheral arterial disease. Because atherosclerosis is a generalised disease, it is possible that patients with peripheral arterial disease may have other arterial disorders. Such patients have a reasonable chance of continuing to walk, although their general prognosis is less favourable because of high cardiovascular morbidity and mortality. Nevertheless, the following approaches can be used to improve the management of patients with peripheral arterial disease: diagnosis of peripheral arterial disease in its early stages by systematic measurement of the ankle/brachial index; improvement in screening for lesions in other arteries by analysing the clinical symptomatology and performing simple complementary examinations; improvement in the management of atherosclerosis risk factors, particularly cigarette smoking, as well as in the treatment of diabetes, arterial hypertension and hypercholesterolaemia; enhancement of antithrombotic agents by the development of new, more effective antiplatelet drugs. Finally, quality of life should be considered an essential factor governing treatment choice. A self-administered questionnaire concerning intermittent claudication has been used to assess the quality of life of patients with peripheral arterial disease undergoing treatment with ifenprodil tartrate. This study showed that the evaluation of intermittent claudication should not be limited to walking distance alone, but that a more general criterion, better adapted to atherosclerotic disease, should be considered: measurement of quality of life.

Arterial Occlusive Diseases↗
PubMed2003

Low bone mineral density in the hip as a marker of advanced atherosclerosis in elderly women.

Previous studies indicate that low bone mineral density (BMD) in the hip is a useful predictor of cardiovascular mortality among the elderly. The objective of this study was to investigate whether low hip BMD is directly associated with the severity of atherosclerosis. The per-protocol population consisted of 963 women aged 60-85 years. Study variables were aortic calcification (AC) graded on lateral lumbar radiographs, BMD at various anatomic sites (distal radius, lumbar spine, proximal femur) measured by DXA, information on various risk factors, and medical history. After adjustment for age, BMD at the proximal femur, but not at the radius or spine BMD, showed statistically significant association with the severity of AC (r = -0.12-17, P < 0.001). Age, years since menopause, BMI, level of education, current and previous smoking, and weekly fitness activity were significant common risk factors (all P < 0.05) with contrasting influence on AC and hip BMD. In a multiple regression model, AC contributed significantly and independently to the variation in hip BMD (beta = -0.10, P = 0.004). Impaired blood flow represented by 40 women with documented history of intermittent claudication was not an independent contributor and did not alter the association between AC and hip BMD. However, AC and demineralization in the hip was particularly severe in women with intermittent claudication accompanied by a higher prevalence of coronary heart disease compared with age-matched controls (all P < 0.001). In conclusion, severe osteoporosis in the hip may indicate advanced atherosclerosis and thereby an increased risk for not only hip fractures but also for coronary heart disease. The results further emphasize that osteoporosis in the hip and peripheral vascular disease are linked by common risk factors and pathomechanisms.

Absorptiometry, Photon↗
PubMed1989

Predictors of disability in elderly Finnish men--a longitudinal study.

Factors predicting disability in late life were studied in 716 men from eastern or southwestern Finland in connection with the 25-year follow-up of the East-West Study, which is part of the Seven Countries Study, in 1984. In middle-aged men, low forced vital capacity, occurrence of diabetes, presence of intermittent claudication, high diastolic blood pressure, higher age and lower educational level showed the greatest predicting power for future disability 15-25 years later. In later middle age, low forced vital capacity, presence of intermittent claudication, cerebrovascular disease or coronary heart disease and higher age were the most powerful predictors for disability 10 years later. In order to lower disability in old age, it is important to prevent deterioration of ventilatory function and cardiovascular diseases in middle-aged populations and to treat chronic diseases adequately.

Aged↗
PubMed1996

[Medical treatment of arteriosclerosis obliterans (ASO)].

The medical treatment of ASO should be approached in three ways. The first should be to minimize the risk factors of "atherosclerosis", the second should be the treatment of leg ischemia, and the third should be the management of other ischemic organs. Among the risk factors involved, cigarette smoking, diabetes mellitus and hyperlipidemia are frequently evident. Smoking must be given up and the other diseases should be controlled by diet, exercise and drug therapy respectively. In order to relieve symptoms such as cold sensation and intermittent claudication, drug therapy such as antiplatelet therapy and vasodilatory drugs are useful in the treatment of some patients with ASO. Daily physical exercises are also effective in extending the walking distance in patients with intermittent claudication. This exercise is even more effective when it is combined with drug therapy. The prevention of vascular events such as myocardial infarction and stroke and the prevention of vascular death are very important in patients with ASO. It can therefore be concluded that antiplatelet therapy is not only effective in relieving symptoms, but also in reducing the incidence of vascular events and death.

Arteriosclerosis Obliterans↗
PubMed1994

Pathogenesis and prevalence of atherosclerosis in hypertensive patients.

Atherosclerosis is important because of its complications that include, for example, myocardial infarction, angina pectoris, stroke, aortic aneurysm, and intermittent claudication. Prospective studies have indicated that the risk-factor patterns for these complications are different in various parts of the cardiovascular tree. For stroke, hypertension is quantitatively the most important risk factor whereas, for intermittent claudication, smoking appears to be by far the most important risk factor. Myocardial infarction, however, is a complication for which a large number of risk factors emerge and none appears to be more important, at least from the statistical point of view, than the others. The prevalence of the different types of complications of atherosclerosis varies considerably among countries. Despite a high prevalence of stroke in Japan and a prevalence of hypertension equal to that in the United States, the prevalence of myocardial infarction is low. This indicates that the importance of hypertension as a risk factor for myocardial infarction is dependent on the presence of other risk factors, such as hypercholesterolemia. In the United States and several European countries, for instance Sweden, there has been a dramatic reduction in the yearly incidence of stroke since the beginning of the 1950s. The time sequence for this change and the change in the number of patients treated for hypertension have been similar in both the United States and Sweden. In contrast, the decrease in the incidence of myocardial infarction began about 15 years later in Sweden than in the United States. In Sweden, the reduced incidence of stroke can be explained by the reduction in the incidence of hemorrhagic stroke only.(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗
PubMed1996

Quality of life in gastric cancer prior to gastrectomy.

A growing number of surgical trials include quality of life variables in the overall assessment of outcomes. This is believed to broaden the criteria for choice of treatment and the evaluation of treatment regimens. The present study is a baseline evaluation of the health-related quality of life in patients with gastric cancer facing surgery. The quality of life in these patients was related to that of other patient groups referred for surgical interventions and general population groups. Our study included 103 consecutive patients with carcinoma of the stomach considered amenable to a curative major surgical procedure. The quality of life evaluation was based on a battery of questionnaires, covering general body symptoms, mood level and functional limitations. Patients with gastric cancer reported more neurasthenic complaints such as reduced sexual interest, insomnia and poor appetite as well as a lower mood level than the general population. The gastric cancer group also showed a markedly lower mood level in comparison with a group of cancer survivors 2-3 years after diagnosis and patients with intermittent claudication. The mental well-being of gastric cancer patients matched that of cancer survivors with one or more recurrences. Overall, 25% of the gastric cancer patients reported functional limitations regarded as clinically significant. Patients with intermittent claudication reported more and patients with small cell lung cancer markedly more limitations. We conclude that although patients with gastric cancer showed a low level of limitations on average, problems in the areas of sleep/rest, home management and, especially, eating were frequently reported.

Adult↗