Murabito Joanne M, Evans Jane C, D'Agostino Ralph B, Wilson Peter W F, Kannel William B
Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, MA 01702-5827, USA.
Am J Epidemiol. 2005 Sep 1;162(5):430-7. doi: 10.1093/aje/kwi217. Epub 2005 Aug 2.
Declines in coronary disease and stroke mortality have occurred, but it remains unclear whether intermittent claudication (IC) incidence and mortality rates have changed. The authors sought to examine long-term trends for IC in the community. Cases of IC among Framingham Study participants aged >or=40 years were classified according to date of onset from the 1950s to the 1990s. IC was defined as the presence of exertional calf discomfort that was relieved with rest. Age- and sex-adjusted incidence rate ratios were estimated using log-linear Poisson regression, and 10-year survival was calculated using the Kaplan-Meier method. IC occurred in 668 participants (286 women). The age- and sex-adjusted incidence rate of IC fell from 282 per 100,000 person-years during the period 1950-1969 to 225 per 100,000 person-years in the 1990s. The decline in IC incidence across time periods was significant (p for trend=0.01), with an initial increase in the 1970s being followed by declines of 16% in the 1980s and 18% in the 1990s. Approximately 40% of persons with IC died within 10 years of diagnosis, with no significant change occurring during the study period. IC incidence has declined since 1950, but mortality has remained high and unchanged. Factors contributing to the declining incidence of IC need clarification.
冠心病和中风死亡率已有所下降，但间歇性跛行（IC）的发病率和死亡率是否发生了变化仍不清楚。作者试图研究社区中IC的长期趋势。根据发病日期，将弗雷明汉心脏研究中年龄≥40岁参与者的IC病例分为20世纪50年代至90年代。IC被定义为运动时小腿出现不适，休息后缓解。使用对数线性泊松回归估计年龄和性别调整后的发病率比，并使用Kaplan-Meier方法计算10年生存率。668名参与者（286名女性）发生了IC。IC的年龄和性别调整发病率从1950 - 1969年期间的每10万人年282例降至20世纪90年代的每10万人年225例。不同时间段IC发病率的下降具有显著性（趋势p值 = 0.01），20世纪70年代初期上升，随后80年代下降16%，90年代下降18%。约40%的IC患者在诊断后10年内死亡，研究期间无显著变化。自1950年以来IC发病率下降，但死亡率仍然很高且无变化。导致IC发病率下降的因素需要进一步明确。
