INTERMITTENT CLAUDICATION AND SUBSEQUENT CARDIOVASCULAR-DISEASE IN THE ELDERLY

Background. This study reports the prevalence of intermittent claudica tion (IC) in ambulatory community-resident adults age 65 years or olde r, compares cardiovascular risk factors and comorbidity of persons wit h and without IC, and examines the independent association of IC in pr edicting ail cause and cardiovascular mortality, myocardial infarction , stroke, and disability. Methods. Data are from a pooled sample of 89 96 older adults from the East Boston, New Haven, and Iowa sites of the Established Populations for Epidemiologic Studies of the Elderly, con ducted between 1982 and 1988. Results. 2.4% and 1.5% of men and women, respectively, reported IC. Persons with IC had significantly higher r ates of diabetes and cardiovascular comorbidity than persons without I C, and they were more likely to smoke: Claudication predicted higher r ates of mortality, myocardial infarction, stroke, and disability indep endent of associated cardiovascular conditions and risk factors. Among persons with a history of angina, myocardial infarction, and/or strok e, those who reported IC had a twofold greater risk of cardiovascular mortality. Conclusion. The study demonstrated that IC is an important predictor of mortality and cardiovascular morbidity in ambulatory olde r adults independent of associated coronary ischemia and cardiovascula r disease risk factors. Results suggest that inclusion of a measure of IC improves the prediction of cardiovascular morbidity and mortality in older adults.