Intermittent claudication: an historical perspective

The present review addresses the history of intermittent claudication in terms of pathogenetic and therapeutic approach. The reduced blood supply to the affected limb was initially explained by ‘vasospasm theory’, and vasodilators were the first drugs to be used. However, the demonstration that they induce the blood steal phenomenon led to the demise of vasodilating therapy. The 1970s marked the shift in interest from ‘vessel’ to ‘blood’, and drugs that improve blood rheology were introduced. In the 1990s, research focused on the metabolic regulation of the ischaemic muscle, and the ‘metabolic therapy’ has emerged as a new approach with which to improve walking capacity in claudicant patients. (Eur Heart J Supplements 2002; 4 (Suppl B): B2‐B7)