Peripheral artery disease, which causes cramping in legs, prevalent among elderly
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The most recent Claudication: Exercise v. Endoluminal Revascularization study indicates the most common treatment for claudication has been to place a stent (a tiny tube) in the blocked artery. The six-month study indicated supervised exercise (walking on a treadmill) increases walking performance better than stenting does, and that both are superior to drugs alone.
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Your legs hurt when you walk. Perhaps the best thing you can do to reduce the pain is to walk more, according to a recent study on claudication.
Claudication, from the Latin word meaning "to limp," is pain or cramping in the lower leg due to diminished blood flow. It's a symptom of peripheral artery disease, a hardening of the arteries due to the accumulation of cholesterol plaque.
These are ailments of the elderly. Fewer than 2 percent of Americans under age 60 suffer from claudication, but 18 percent of Americans over 70 do. Men are far more likely than women to have claudication. African- American men, and men who smoke or who have high cholesterol levels are especially vulnerable.
"This is a huge and growing problem as the elderly population grows," said Robert Biederman, an intervention cardiologist at Allegheny General Hospital who took part in a 2008 study on claudication. "It chews up lots of hospital resources."
The most recent CLEVER (Claudication: Exercise v. Endoluminal Revascularization) study was reported on last month at a meeting of the American Heart Association and published in the current issue of Cardiology Today.
The most common treatment for claudication has been to place a stent (a tiny tube) in the blocked artery. The six-month CLEVER study indicated supervised exercise (walking on a treadmill) increases walking performance better than stenting does, and that both are superior to pharmacotherapy (drugs) alone.
"This is the first trial that systematically looked at this," Dr. Biederman said. "It appears that pharmacological intervention without the supervised exercise is not beneficial."
There was an odd finding in the study which indicates the need for more research, Dr. Biederman said. Although the patients in the study who did the supervised exercise improved their walking more, the patients who received stents said they felt better.
"We don't have an understanding yet of the mechanism of the treatment benefit," he said.
Cardiologists like himself have always focused primarily on physical results, Dr. Biederman said. "We care about whether you are alive or dead, not how you felt before treatment."
The CLEVER study suggests quality of life issues should receive more consideration, he said.
"The hope is that supervised exercise will have both improvements in objective measurements and in quality of life measurements."
First Published December 12, 2011 12:00 am
