Intended for healthcare professionals

Clinical Review

Intermittent claudication

BMJ 2006; 333 doi: (Published 09 November 2006) Cite this as: BMJ 2006;333:1002
  1. Kevin Cassar, senior lecturer
  1. 1Vascular Unit, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN
  1. k.cassar{at}
  • Accepted 5 October 2006

Intermittent claudication is pain affecting the calf, and less commonly the thigh and buttock, that is induced by exercise and relieved by rest. Symptom severity varies from mild to severe. Intermittent claudication occurs as a result of muscle ischaemia during exercise caused by obstruction to arterial flow. It is a common problem, with a prevalence of 0.6-10%1 which increases significantly with age. Almost a fifth of the population over the age of 65 has intermittent claudication,2 and, as a result of demographic changes in many developed countries, its prevalence in the general population is likely to rise dramatically over the next 20 years.

Summary points

  • Intermittent claudication is a common condition and in most cases is easily diagnosed

  • It is associated with a significantly increased risk of death from cardiovascular disease

  • Only a small proportion of patients with claudication require revascularisation

  • The main treatment aim is to reduce the risk of mortality from cardiovascular events

  • Smoking cessation, control of hypertension and diabetes, and prescription of statins and antiplatelet drugs are key elements for treating the condition

  • Exercise, angioplasty, and bypass surgery can improve symptoms of claudication

Intermittent claudication has a negative impact on various aspects of quality of life3 and on affected people's ability to continue to work. Its socioeconomic impact has not been evaluated but is likely to be considerable. More importantly, people with intermittent claudication have a significantly increased mortality risk. However, many people with the condition do not consult a doctor, and often doctors are unaware that their patients have the condition.w1 Early diagnosis and risk factor control by primary care doctors is critical to reducing the mortality associated with claudication. This review presents current knowledge on the diagnosis, natural course, and management of intermittent claudication.

Search strategy

I searched the Cochrane Library for relevant systematic reviews …

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