Treatment of hypertension in peripheral arterial disease

Lip, Gregory Y.H.; Makin, Andrew

doi:10.1002/14651858.cd003075

Cited by 14 publications

(8 citation statements)

References 47 publications

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“…Our findings agreed with Lip et al 26 who found hypertension in 55% of arteriopathic patients studied in a systematic review. Evaluating in isolation our hypertensive population, we found 25% of arteriopathic patients, which was statistically higher than that of non-hypertensive patients (25% versus 17%, p < 0,05).…”

Section: Discussionsupporting

confidence: 94%

Study of Risk Factors Associated with Peripheral Arteriopathy in Japanese-Brazilians from Bauru (SP)

Garofolo¹,

Ferreira²,

Miranda³

2014

Arquivos Brasileiros De Cardiologia

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BackgroundCardiovascular diseases are the major cause of morbidity and mortality in developed and emerging countries. Their main etiology, atherosclerosis, is a disseminated disease that affects the coronary, cerebral and peripheral territories. The peripheral arterial disease (PAD), as well as its consequences, indicates the involvement of the coronary territory. Therefore, its better understanding enables proper treatment, delaying local and long-term complications, reducing the cost to the health system. Objective This study estimates the percentage of PAD in Japanese-Brazilians from Bauru (SP), recognized by the high prevalence of metabolic disorders such as hypertension (43%), diabetes mellitus (33%) and hypercholesterolemia (60%), and examines the association with risk biomarkers. MethodsThis cross-sectional population study evaluated 1,330 Japanese-Brazilians of both genders aged ≥ 30 who underwent a complete physical examination, anthropometric measurements, laboratory tests and ankle-brachial index (ABI). Participants with ABI ≤ 0.90 were diagnosed as having PAD. After applying the exclusion criteria, 1,038 individuals were part of the analysis. We used Poisson regression to analyze associations with PAD. Results The mean age was 56.8 years and the percentage of PAD was 21.1%, equal among the genders. PAD was associated with smoking (PR 2.16 [1.33 to 3.48]) and hypertension (PR 1.56 [1.12-2.22]). ConclusionThe percentage of PAD in Japanese-Brazilians was similar to other populations of adverse cardiometabolic profile (US PARTNERS and POPADAD). The independent association of PAD with smoking and hypertension, but not with other classical risk factors, may depend on the very high frequencies of metabolic disorders in this population.

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Section: Discussionsupporting

confidence: 94%

Study of Risk Factors Associated with Peripheral Arteriopathy in Japanese-Brazilians from Bauru (SP)

Garofolo¹,

Ferreira²,

Miranda³

2014

Arquivos Brasileiros De Cardiologia

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“…A large reduction in blood pressure may initially worsen intermittent claudication, independent of what drug treatment is used. There is no evidence that beta blockers are particularly culpable, as has been suggested previously [56,57]. ACE inhibitors showed significantly greater hemodynamic improvements in the extremity in which baseline blood flow is decreased by limb arterial atherosclerosis compared with either calcium channel blockers or beta blockers [58,59].…”

Section: Risk Factor Modificationmentioning

confidence: 99%

Medical management of peripheral arterial disease

Bendermacher

Willigendael

Teijink

et al. 2005

Journal of Thrombosis and Haemostasis

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Summary. Whether symptomatic or not, peripheral arterial disease (PAD), atherosclerosis in the arteries of the lower extremities, is a common disorder in the general population. The prevalence increases with age and under the influence of vascular risk factors. The most classic symptomatic expression of PAD is intermittent claudication. However, the majority of patients with PAD is asymptomatic or has leg symptoms other than classic intermittent claudication. Both symptomatic and asymptomatic subjects with PAD have increased mortality rates, mainly due to cardiovascular and cerebrovascular expressions of atherosclerotic disease. This review focuses on the current available medical therapies for PAD, including risk‐factor modification and antiplatelet therapies, as well as strategies for symptomatic relief in both patients with intermittent claudication and patients with critical limb ischemia. In general, risk factor modification and antiplatelet therapy is essential in all patients with PAD to prevent systemic atherosclerotic complications. Furthermore, for symptomatic relief exercise therapy is the main intervention while pharmacological treatment should be only complementary. In patients with critical limb ischemia, when revascularization therapy is not possible, an attempt should be made to avoid amputation with conservative treatment using analgesics, vasodilators and/or anticoagulants. In case of an acute onset of critical limb ischemia, thrombolysis is indicated.

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“…39 Walking symptoms in PAD may also improve with the use of angiotensin-converting enzyme inhibitors in patients with hypertension. 40 A meta-analysis of randomized controlled trials concluded that ␤ -blockers do not worsen PAD symptoms and may be used in PAD management. 41 On the basis of the current literature, there is no evidence that these agents will adversely affect walking distance in patients with PAD.…”

Section: ␤ -Blockersmentioning

confidence: 99%