Exertional Leg Symptoms Other Than Intermittent Claudication Are Common in Peripheral Arterial Disease

Abstract

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.

Pulse pressure and michigan neuropathy screening instrument are independently associated with asymptomatic peripheral arterial disease among type 2 diabetes community residents: A community-based screening program in Taiwan

“…Most patients with PAD do not have typical intermittent claudication, [1,2] and the ABI is recommended as a non-invasive screening tool for early detection. [10] In our study, we examined the prevalence of PAD in asymptomatic type 2 diabetic patients and found that its occurrence was significantly associated with pulse pressure, age, history of stroke and a high MNSI score in multivariate logistic regression analysis.…”

“…In addition, the progression of PAD may be more rapid with poorer outcomes. [1][2][3][4] PAD also plays a major role in low-extremity amputation in these patients. [1,4,5] For decades, the ankle-brachial index (ABI) has been used as a simple, rapid and effective tool for PAD screening.…”

“…Participants were excluded if they had subjective symptoms of intermittent claudication or a history of PAD, subclavian or brachiocephalic occlusive disease, proximal iliac artery disease. We also excluded those who did not: (1) complete the questionnaires (with regards to age, intermittent claudication, history of foot ulcers, history of previous amputations); (2) complete height, weight and blood pressure recording; and (3) have MNSI and ABI measurements. In total, 552 type 2 diabetic patients completed the entire screening process.…”

Diabetes Mellitus, Smoking, and the Risk for Asymptomatic Peripheral Arterial Disease: Whom Should We Screen?

“…[1][2][3][4] Previous research has outlined risk factors associated with PAD, which include diabetes mellitus, hypertension, older age, and dyslipidemia. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] A higher prevalence of PAD has also been found among older African Americans and Hispanics when compared with whites. 11,12 Research has shown that 53.8% of patients with PAD within a general medicine practice are asymptomatic.…”

Lack of Benefits of Endurance Training in Patients with Chronic Heart Failure: Role of Asymptomatic Peripheral Artery Disease

“…The association of PAD with lower exercise capacity and lack of benefit to exercise training in HF subjects has been recently demonstrated in retrospective studies [6,7]. However most patients with PAD do not have classic intermittent claudication symptoms either because of their asymptomatic or because they have exertional leg symptoms other than intermittent claudication such as pain that does not cause the patient to stop walking or pain in different sites that not resolve early after rest [8]. Epidemiological studies have found that asymptomatic PAD is three to four times more common than symptomatic types in the general population [9,10].…”