Intermittent claudication: prevalence and risk factors.

Hughson, William G.; Mann, J I; Garrod, Andrea S.

doi:10.1136/bmj.1.6124.1379

Cited by 276 publications

(87 citation statements)

References 12 publications

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“…Although normal arterial stiffening occurs in individuals in association with age, some risk factors hasten this process 28,29) . Cardiovascular diseases (CVDs), such as hypertension and diabetes, are proven risk factors for arterial stiffness, while social and environmental factors, such as drinking, smoking and stress, accelerate the progression of arterial stiffness [30][31][32] . In the present study, we found a higher effect of aging in men than in women, when adjusted for BMI, waist circumference, SBP, DBP, FPG, TG and HDL.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of High Arterial Stiffness and Gender-specific Differences in the Relationships with Classical Cardiovascular Risk Factors

Wen

Peng

Tang

et al. 2015

J Atheroscler Thromb

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Aim:To investigate the relationships between arterial stiffness and classic cardiovascular risk factors with respect to gender differences in addition to the prevalence of high arterial stiffness in Chongqing, China based on an examination of 18,336 subjects. Methods: The cardio-ankle vascular index was used as a marker of arterial stiffness. The relationships between arterial stiffness and body mass index (BMI) as well as metabolic syndrome (MetS) were estimated using logistic regression models. Results: The prevalence of high arterial stiffness was 12.74% in men and 9.91% in women. For age and BMI, compared with the reference group, men had higher adjusted odds ratios (ORs) in each group versus their female counterparts. For each individual index of MetS, the effects of waist circumference and systolic blood pressure (SBP) on high arterial stiffness exhibited remarkable gender differences, with women having higher ORs and adjusted ORs than men. As the sum of MetS traits increased, the ORs and adjusted ORs in the subjects also increased, with women having higher values than men in each group. Conclusions: Gender-specific differences exist in the prevalence of high arterial stiffness among subjects compared by age, BMI and MetS, with varying effects of influence for these factors between genders.J Atheroscler Thromb, 2015; 22: 706-717.

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Section: Discussionmentioning

confidence: 99%

Prevalence of High Arterial Stiffness and Gender-specific Differences in the Relationships with Classical Cardiovascular Risk Factors

Wen

Peng

Tang

et al. 2015

J Atheroscler Thromb

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“…The ability of cilostazol to favorably modify plasma triglycerides and HDL-C is particularly significant for patients with IC, in that both hypertriglyceridemia and low HDL-C are observed with increased frequency in such patients. [13][14][15][16][17] Reduced plasma triglycerides may be desirable in this patient population, as elevated plasma triglyceride levels are associated with increased risk of cardiovascular disease independent of HDL-C. 18,19 The exact mechanisms involved in the ability of cilostazol to lower plasma triglycerides and increase HDL are at present unknown. The lipoprotein effects of cilostazol that we have observed appear to be independent of changes in physical activity or glucose tolerance and are unaffected by concomitant ␤-antagonist therapy.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Novel Antiplatelet Agent Cilostazol on Plasma Lipoproteins in Patients With Intermittent Claudication

Elam

Heckman²,

Crouse³

et al. 1998

ATVB

211

132

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Abstract-Cilostazol is an antiplatelet agent and vasodilator marketed in Japan for treatment of ischemic symptoms of peripheral vascular disease. It is currently being evaluated in the United States for treatment of symptomatic intermittent claudication (IC). Cilostazol has been shown to improve walking distance in patients with IC. In addition to its reported vasodilator and antiplatelet effects, cilostazol has been proposed to have beneficial effects on plasma lipoproteins. We examined the effect of cilostazol versus placebo on plasma lipoproteins in 189 patients with IC. After 12 weeks of therapy with 100 mg cilostazol BID, plasma triglycerides decreased 15% (PϽ0.001). Cilostazol also increased plasma high density lipoprotein cholesterol (HDL-C) (10%) and apolipoprotein (apo) A1 (5.7%) significantly (PϽ0.001 and PϽ0.01, respectively). Both HDL 3 and HDL 2 subfractions were increased by cilostazol; however, the greatest percentage increase was observed in HDL 2 . Individuals with baseline hypertriglyceridemia (Ͼ140 mg/dL) experienced the greatest changes in both HDL-C and triglycerides with cilostazol treatment. In that subset of patients, HDL-C was increased 12.2% and triglycerides were decreased 23%. With cilostazol, there was a trend (3%) toward decreased apoB as well as increased apoA1, resulting in a significant (9.8%, PϽ0.002) increase in the apoA1 to apoB ratio. ilostazol is a vasodilator and platelet aggregation inhibitor that has been marketed since 1988 in Japan for treatment of ischemic symptoms of peripheral vascular disease. Cilostazol {6[4-(1-cyclohexyl-1H-tetrazol-5-yl)butoxy]-3,4-dihydro-2-(1H)-quinolinone} is a 2-oxoquinolone derivative (molecular weight, 369.47) that has a plasma half-life of 10.5Ϯ4.4 hours after oral administration (Figure 1). Cilostazol inhibits both primary and secondary platelet aggregation in response to ADP, collagen, epinephrine, and arachidonic acid.1,2 The antiplatelet and vasodilator properties of cilostazol have been attributed to its ability to elevate intracellular levels of cAMP.3 Cilostazol is currently being evaluated in the United States for treatment of symptomatic intermittent claudication (IC). Japanese studies performed in diabetic patients have indicated that, in addition to its vasodilator and antiplatelet properties, cilostazol may also favorably modify plasma lipoproteins by increasing HDL cholesterol (HDL-C) and reducing triglycerides. 4 The purpose of the present study was to determine whether cilostazol favorably modifies plasma lipoproteins in a general population of patients with stable IC. Methods Patient PopulationThe study included subjects with documented chronic, stable, symptomatic IC secondary to peripheral arterial disease (PAD). PAD was defined as an ankle-brachial index (ABI) Յ0.90; termination of walking on a variable-load, constant-speed treadmill due to IC (Ͼ54 and Ͻ805 m); and a Doppler-measured drop of Ն10 mm Hg in blood pressure of 1 ankle after the treadmill test. For patients without a qualifying ABI, a 20 -mm Hg drop in postexe...

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“…Approximately 5% of individuals who develop asymptomatic or symptomatic PAD also present with diabetes [12][13][14]. Diabetes is relatively more prevalent in individuals with symptomatic PAD (i.e.…”

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confidence: 99%

Effect of type 2 diabetes mellitus on exercise intolerance and the physiological responses to exercise in peripheral arterial disease

2007

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Aims/hypothesis There are conflicting data about the effect of type 2 diabetes mellitus on exercise tolerance in peripheral arterial disease. To elucidate this problem, we compared the tolerance and physiological responses to treadmill and cycle exercise in 31 patients with peripheral arterial disease and intermittent claudication. Materials and methods One group of these patients had type 2 diabetes (n=12) and its members were matched for sex and age with a group of patients who did not have diabetes (n=12). Since BMI and body weight were greater in the diabetic group (28.4±3.7 vs 25.2±2.4 kg/m 2 ; 84.0± 14.6 vs 73.8±8.0 kg), we also studied a third, 'heavy' group of non-diabetic patients with claudication of similar age (n=7; BMI = 30.9±5.3 kg/m 2 ; body weight = 85.2± 8.2 kg). Results Compared with the 'light' non-diabetic group, maximum treadmill times were shorter for the diabetic and heavy non-diabetic groups (1,448 vs 845 and 915 s; ANOVA p=0.01); maximum cycle time also tended to be shorter (ANOVA, p=0.08) in the diabetic and heavy nondiabetic groups (median = 1,231 vs 730 and 797 s). The majority of physiological responses assessed were not different between the groups, although the time constant of oxygen uptake during submaximal treadmill and cycle exercise was significantly larger (ANOVA p<0.05) for the diabetic group. Conclusions/interpretation These data demonstrate that exercise tolerance is lower in diabetic than non-diabetic patients with claudication, but that this difference is due to obesity rather than diabetes itself.

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Intermittent claudication: prevalence and risk factors.

Cited by 276 publications

References 12 publications

Prevalence of High Arterial Stiffness and Gender-specific Differences in the Relationships with Classical Cardiovascular Risk Factors

Prevalence of High Arterial Stiffness and Gender-specific Differences in the Relationships with Classical Cardiovascular Risk Factors

Effect of the Novel Antiplatelet Agent Cilostazol on Plasma Lipoproteins in Patients With Intermittent Claudication

Effect of type 2 diabetes mellitus on exercise intolerance and the physiological responses to exercise in peripheral arterial disease

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