Conservative treatment for patients with intermittent claudication.
OBJECTIVE
The effect of pharmacotherapy or supervised exercise training on patients with intermittent claudication was assessed.


METHODS
One hundred patients with stable intermittent claudication due to arteriosclerosis obliterans were analyzed. We divided the patients into 2 groups: patients treated by pharmacotherapy alone (Group A: 39 claudicants) and patients treated by supervised exercise training and pharmacotherapy (Group B: 61 claudicants). The changes in ankle-brachial pressure index (ABI) and recovery time of ABI after a 40-m walk (RT(40)) and absolute claudication distance (ACD) on a treadmill before and after each treatment were assessed.


RESULTS
In Group A, RT(40) decreased from 9.5 +/- 5.8 min at the baseline to 6.4 +/- 3.5 min after 6 months (P=0.0002). In Group B, it decreased from 9.7+/-5.2 min at the baseline to 6.3+/-4.2 min after 3 weeks (P<0.0001). In Group A, ACD increased from 249+/-177 m at the baseline to 317+/-168 m after 6 months (P=0.0003). In Group B, it increased from 143+/-90 m at the baseline to 257+/-161 m after 3 weeks (P<0.0001).


CONCLUSIONS
Hemodynamics and walking ability were improved by either short-term supervised exercise training or midterm pharmacotherapy. RT(40) may be useful for predicting the effect of conservative treatment on intermittent claudication. Greater increases in ACD after treatment can be achieved in claudicants with a shorter RT(40) before conservative treatment.
Sugimoto
I
I
Department of Vascular Surgery, Aichi Medical University, Nagakute-cho, Aichi, Japan. takum@surg2.med.kyushu-u.ac.jp
Ohta
T
T
Ishibashi
H
H
Iwata
H
H
Yamada
T
T
Tadakoshi
M
M
Hida
N
N
Orimoto
Y
Y
D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001162:Arteriosclerosis Obliterans / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000187:drug effects; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000187:drug effects; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents