Intermittent Claudication

Intermittent claudication is only a symptom of PVD and can be misleading in measuring the prevalence of PVD. For example, a patient with advanced PVD may not have significant IC due to functional decline and inactivity, whereas those who are very active may have significant IC even if they only have mild disease. Several questionnaires, such as the World Health Organization (WHO)/Rose, Edinburgh Claudication, and Walking Impairment questionnaires, have been developed to identify patients with IC. The prevalence of IC based on the Rose criteria ranged from 0.4% to 14% of the adult population (Dormandy and Rutherford, 2000). Although these questionnaires are typically highly specific in excluding healthy patients, as assessed by a physician, they are only moderately sensitive in detecting disease. Only about one third of patients with PVD have typical symptoms of IC (Schroll and Munck, 1981; Zheng et al., 1997). Furthermore, asymptomatic patients are not at all detected by questionnaire screening. These individuals can only be diagnosed with noninvasive or invasive imaging. Therefore, epidemiologic studies based solely on the use of questionnaires significantly underestimate the true prevalence of disease.

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