ß-Adrenergic Blockers and Intermittent Claudication

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Abstract
Therapy with β-adrenergic blockers is often indicated in patients with coronary artery disease (CAD) and exerts beneficial effects in survivors of myocardial infarction. Yet in patients with CAD who have concomitant intermittent claudication, β-blockers are considered to be relatively contraindicated. In this issue of the ARCHIVES, Radack and Deck1 have reviewed the published reports on the effect of β-blockers on walking distance in patients with intermittent claudication and have concluded that claudication distance or calf blood flow is not adversely effected. Intermittent claudication is most commonly caused by atherosclerotic peripheral arterial disease (PAD) and represents the symptoms of skeletal muscle ischemia that occurs during exercise. The incidence increases sharply with age, with roughly about a twofold male predominance at all ages.2 In an older population (average age, 66 years), the prevalence of PAD (11.7%) and isolated smallvessel PAD (16%) was reported to be greater than the prevalence of