Intermittent claudication

Abstract

Intermittent claudication is pain affecting the calf, and less commonly the thigh and buttock, that is induced by exercise and relieved by rest. Symptom severity varies from mild to severe. Intermittent claudication occurs as a result of muscle ischaemia during exercise caused by obstruction to arterial flow. It is a common problem, with a prevalence of 0.6-10%1 which increases significantly with age. Almost a fifth of the population over the age of 65 has intermittent claudication,2 and, as a result of demographic changes in many developed countries, its prevalence in the general population is likely to rise dramatically over the next 20 years. Intermittent claudication has a negative impact on various aspects of quality of life3 and on affected people’s ability to continue to work. Its socioeconomic impact has not been evaluated but is likely to be considerable. More importantly, people with intermittent claudication have a significantly increased mortality risk. However, many people with the condition do not consult a doctor, and often doctors are unaware that their patients have the condition.w1 Early diagnosis and risk factor control by primary care doctors is critical to reducing the mortality associated with claudication. This review presents current knowledge on the diagnosis, natural course, and management of intermittent claudication.