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Circulation. 1970;41:875-883

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(Circulation. 1970;41:875.)
© 1970 American Heart Association, Inc.


Intermittent Claudication

Incidence in the Framingham Study

WILLIAM B. KANNEL M.D.1; JOHN J. SKINNER JR. M.D.1; MELVIN J. SCHWARTZ M.D.1; DEWEY SHURTLEFF 1

1 From the Heart Disease Epidemiology Study, Framingham, Massachusetts, and the National Heart and Lung Institute, National Institutes of Health, U. S. Public Health Service, Washington, D. C.

A general population sample of adult men and women was followed biennially over 14 years during which time 79 men and 46 women developed initial symptoms of intermittent claudication. A detailed examination of the incidence of this manifestation of atherothrombosis in comparison to that of coronary heart disease and atherothrombotic brain infarction was undertaken.

As for coronary heart disease (CHD), the incidence of intermittent claudication increased with age. Women lagged behind men by 10 years in incidence. Atherothrombotic brain infarction in contrast exhibited no male predominance and after the early sixties the women actually surged ahead.

Uncomplicated angina, surprisingly, resembled brain infarction more than intermittent claudication in the age-sex trend.

A pronounced increase in risk of intermittent claudication was noted for persons with CHD in general and angina in particular, suggesting a common underlying basis for claudication and coronary disease. The principal hazard for subjects with claudication appeared to derive from an increased propensity to cardiovascular morbidity and mortality rather than from the consequences of impaired circulation to the limb. Risk of death was twofold for those with claudication as compared to those without.


Key Words: Angina pectoris • Coronary heart disease • Perfusion • Atherothrombosis • Arterial insufficiency • Brain infarction • Mortality

Submitted on December 12, 1969
Accepted on January 19, 1970




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