Dagenais G R, Maurice S, Robitaille N M, Gingras S, Lupien P J
Department of Medicine, Faculty of Medicine, Laval University, Québec.
Clin Invest Med. 1991 Apr;14(2):93-100.
The incidence and risk factors of intermittent claudication (IC) and its association with coronary heart disease were evaluated in a cohort of 4570 men, aged 35 to 64 in 1973, free of cardiovascular diseases and followed for 12 years. During the follow-up, 188 developed IC, an annual incidence of 41/10,000. The risk of IC increased with age. In comparison to the rest of the cohort, men with IC were older and had a higher prevalence of smoking, elevated blood pressure, and diabetes. Cigarette smoking was the predominant factor, quadrupling the risk of IC compared to those who never smoked, while those who stopped smoking one year before the study had a risk similar to non-smokers. Quintile 5 of systolic blood pressure doubled the risk of IC. Diabetes requiring a pharmacological treatment at entry in the study was significantly more prevalent in men with than in men without IC (7.5% vs 1.5%). There was no significant relationship between IC and serum cholesterol, body weight, or number of years at school. During the follow-up, 84 of the 188 men with IC had a coronary heart disease event, angina being the most frequent manifestation. Furthermore, 11% of men with IC died and in nearly two-thirds of these, death was attributable to coronary heart disease; this was twice the rate observed in the other men. In these Quebec men, IC is a common health problem and is associated with a high rate of coronary heart disease. Since IC is related to modifiable risk factors, primary prevention of these factors appears warrant.
在一个由4570名男性组成的队列中,评估了间歇性跛行(IC)的发病率、危险因素及其与冠心病的关联。这些男性在1973年年龄为35至64岁,无心血管疾病,并随访了12年。随访期间,188人发生了IC,年发病率为41/10000。IC的风险随年龄增加而升高。与队列中的其他男性相比,患有IC的男性年龄更大,吸烟、血压升高和糖尿病的患病率更高。吸烟是主要因素,与从不吸烟的人相比,IC风险增加了四倍,而在研究前一年戒烟的人风险与不吸烟者相似。收缩压五分位数第5组使IC风险增加一倍。在研究开始时需要药物治疗的糖尿病在患有IC的男性中比没有IC的男性中更为普遍(7.5%对1.5%)。IC与血清胆固醇、体重或上学年限之间没有显著关系。随访期间,188名患有IC的男性中有84人发生了冠心病事件,心绞痛是最常见的表现。此外,患有IC的男性中有11%死亡,其中近三分之二的死亡归因于冠心病;这是其他男性中观察到的比率的两倍。在这些魁北克男性中,IC是一个常见的健康问题,并且与高冠心病发生率相关。由于IC与可改变的危险因素有关,对这些因素进行一级预防似乎是必要的。