2-3% of men and 1-2% of women over the age of 60 years.

Incidence range from 2 per 1,000 men per year in the 30-34-year-old group to 7 per 1,000 in those over 65 years.

Occurs in 1 of every 20 people > 65 years of age in the general population.

Higher rates of occurrence seen in older adults, especially among smokers and those with diabetes.

Usually indicative of systemic atherosclerosis disease with almost 60% of people with peripheral arterial disease also having significant disease of the cerebral or cardiac circulation.

Approximately one third of patients with PAD.

Relative risk for developing intermittent claudication increases about 2 to 3 fold for male patients and each additional decade of life.

Smokers carry a three times higher relative risk of developing intermittent claudication and experience symptoms an average of 10 years earlier than nonsmokers.

Diabetes carries a 2-fold higher risk for claudication compared with their nondiabetic counterparts.

Only 10% of patients with intermittent claudication have normal coronary arteries.

Typically present as pain within leg muscles, occurring with walking and relieved by rest.

Foot pain is almost never directly due to claudication.

Approximately 75% of all patients experience symptom stabilization or improvement over their lifetime without the need for intervention.

Approximately 5% will undergo an intervention within 5 years.

With intermittent claudication impairment in ambulatory ability, resulting in dysfunction and lifestyle limitation.

Approximately 2-4% will require a major amputation.

Ankle:brachial index of 0.5 on initial diagnosis is the most significant predictor for peripheral arterial disease deterioration requiring intervention.

Unlike neurogenic claudication, vascular claudication typically is not improved by postural changes.

Treatment with drugs have limited efficacy with an increase in walking distance between 12-60%.

Pentoxifylline treatment increases walking distance by 15%, and cilostazol by 25% (Stevens JW et al).

Rampiril, an ACE inhibitor, results in increased pain- free and maximum treadmill walking times compared with placebo (Ahimatos AA et al).

For patients with intermittent claudication antiplatelet therapy is associated with lower all-cause and cardiovascular disease mortality compared with placebo.

Comparing all platelet antiplatelet therapies, the strongest evidence exists for thienopyridines, such as clopidogrel.

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