Intermittent claudication: factors determining outcome.

Abstract

and conclusions Two groups of patients were followed up for four to eight years after first referral or admission to hospital for intermittent claudication (IC) in a study of the natural history of the disease and of factors determining its outcome. In one series of 60 patients, those who stopped or reduced smoking after referral had a much improved prognosis. Thus even after the diagnosis of IC it is extremely important that patients should be encouraged to stop smoking, since this correctable factor appears to be of greater importance in determining outcome than other medical risk factors for the disease that are less amenable to treatment. In the second study, 160 patients were followed up for eight years after first hospital admission. They had a total of 480 hospital admissions and had spent 11 190 days in hospital; their life expectancy after the age of 60 was about half that of the general population. Age, coronary artery disease, cerebrovascular disease, and diabetes were associated with an adverse outcome.

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

“…2,13,15,19,26 Previously it has been found that current smoking status has a greater effect on PAD than a lifetime history of smoking, because it has been shown that smoking cessation significantly reduces cardiovascular complications. [27][28][29][30][31] As this study focused on the patient's lifetime smoking history, it can only be inferred from our results that a history of heavy smoking is associated with asymptomatic PAD.…”

Why smoke fewer cigarettes?

“…'0 11 Their truthfulness is usually tested by measuring serum thiocyanate or carboxyhaemoglobin concentrations. [8][9][10] When our subjects smoked fewer cigarettes their carboxyhaemoglobin concentrations were not significantly different from steady-state values; thus it could be argued that they were being dishonest. Two important factors, however, should be considered.…”

Drug treatment of intermittent claudication: a critical analysis of the methods and findings of published clinical trials, 1965‐1985 [see comments]

“…Regular exercise (Ekroth et al, 1978;Clifford et al, 1980) and stopping smoking (Quick & Cotton, 1982) may improve symptoms of claudication, and the latter also benefits associated coronary artery or cerebrovascular disease (Hughson et al, 1978), which are the main determinants of prognosis in patients with peripheral vascular disease (Reunanen et al, 1982). It is also customary to control concomitant hypertension and diabetes, although there is no evidence that either measure improves the symptoms of intermittent claudication.…”