[Intermittent claudication in Italy. The Peripheral Arteriopathy and Cardiovascular Events (PACE) study].
BACKGROUND
The epidemiology of intermittent claudication in the primary care settings has been studied almost exclusively in northern European and northern American populations. This article compares the results of the Peripheral Arteriopathy and Cardiovascular Events (PACE) study, the first survey in Italy to assess the prevalence, comorbidity and natural history of intermittent claudication, with those observed in other western countries.


METHODS
From the lists of seven general practitioners, all patients aged 40-80 years (n = 4352) received a Rose questionnaire. In those reporting leg pain while leg pain while walking (n = 760), Doppler examination was performed. Intermittent claudication was defined as an ankle/branchial index of < 0.90, or reduced flow velocity. For each claudicant, three age- and sex-matched controls were randomly selected from patients negative to the questionnaire.


RESULTS
The prevalence of both intermittent claudication (1.6%) and associated cardiovascular disease (34%) tended to be lower in Italy than in the United Kingdom, Netherlands, and North America. Conversely, no between country difference was observed with respect to mortality, which was very high (relative risk 4.08; 95% confidence interval 1.50-10.84, p = 0.006) in the PACE claudicants.


CONCLUSIONS
In this regard it is noteworthy that these patients, who were managed almost exclusively by their general practitioner were undertreated with respect to the use of antiplatelet therapy and correction of risk factors. There is need to alert them to this topic.
Brevetti
Gregorio
G
Dipartimento di Medicina Clinica, Scienze Cardiovascolari e Immunologiche, Università degli Studi "Federico II", Napoli. brevetti@unina.it
Oliva
Gabriella
G
Sirico
Giusy
G
Giugliano
Giuseppe
G
Chiariello
Massimo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007383:Intermittent Claudication / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009656:North America / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology