Exertional leg symptoms other than intermittent claudication are common in peripheral arterial disease

Mary Mc Grae McDermott*, Shruti Mehta, Philip Greenland

*Corresponding author for this work

Research output: Contribution to journalArticle

134 Scopus citations

Abstract

Background: Epidemiological data show that most community-dwelling men and women with lower-extremity peripheral arterial disease (PAD) do not have typical symptoms of intermittent claudication. We compared the prevalence of intermittent claudication, leg symptoms other than intermittent claudication, and absence of exertional leg symptoms between patients with PAD identified from a blood flow laboratory (group 1), patients with PAD in a general medicine practice (group 2), and control patients without PAD (group 3). Methods: Numbers of participants in groups 1, 2, and 3 were 137, 26, and 105, respectively. Patients with previously diagnosed PAD were excluded from groups 2 and 3. All participants underwent ankle-brachial index measurement and were administered the San Diego claudication questionnaire to assess leg symptoms. Results: Within groups 1, 2, and 3, prevalences of intermittent claudication were 28.5% (n = 39), 3.8% (n = 1), and 3.8% (n = 4), respectively. Prevalences of exertional leg symptoms other than intermittent claudiCation were 56.2% (n=77), 42.3% (n= 11), and 19.0% (n = 20), respectively. Absence of exertional leg symptoms was reported by 15.3% (n = 21), 53.8% (n = 14), and 77.1% (n= 81), respectively. Among patients with PAD, older age, male sex, diabetes mellitus, and group 2 vs group 1 status were associated independently with absence of exertional leg symptoms in multivariable regression analysis. Lower ankle-brachial index levels and group 1 vs group 2 status were associated with intermittent claudication. Conclusions: Clinical manifestations of PAD are diverse, particularly among patients identified by ankle-brachial index screening. Exertional leg symptoms other than intermittent claudication are common in PAD. Patients with PAD who are older, male, diabetic, or identified with ankle-brachial index screening in a primary care setting are more likely to have asymptomatic PAD.

Original languageEnglish (US)
Pages (from-to)387-392
Number of pages6
JournalArchives of Internal Medicine
Volume159
Issue number4
DOIs
StatePublished - Feb 22 1999

ASJC Scopus subject areas

  • Internal Medicine

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