PERIPHERAL VASCULAR-DISEASE - CONSEQUENCE FOR SURVIVAL AND ASSOCIATION WITH RISK-FACTORS IN THE SPEEDWELL PROSPECTIVE HEART-DISEASE STUDY

Objective-To measure the prevalence and incidence of intermittent clau dication, to describe the mortality associated with the condition, and to assess the relevance of risk factors for vascular disease. Design- A standard questionnaire on calf pain when walking was given in the pr ospective Speedwell study, and a range of risk factors were measured. The men were re-examined at intervals of three years, and deaths over 11 years were identified. Setting-The general population. Participants -All men aged 45 to 59 registered with 16 general practitioners. Resul ts-The prevalence of intermittent claudication increased from almost n il at ages 45-49 to 2.9% at ages 60-64. The annual incidence increased from 0.3% in the youngest men to 0.5% in those in their early 60s. In termittent claudication was related to the existence of ischaemic hear t disease, particularly angina, at the first examination. The relative odds of men with angina developing intermittent claudication was 6.7 (95% confidence interval (95% CI) 3.6 to 12.4). The risk of death in m en with intermittent claudication was substantially raised. After stan dardisation for age and smoking the relative odds of death was 3.8 (95 % CI 2.2 to 6.5). The excess was entirely from circulatory causes. Sys tolic blood pressure, fasting plasma glucose, triglycerides, and white cell count were all independently associated with the development of intermittent claudication, but the most striking association was with smoking. Conclusions-Intermittent claudication is an indicator for a v ery high risk of death. This is only partly explained by its strong as sociation with ischaemic heart disease.