Peripheral arterial disease and hypertension

Abstract

Purpose of reviewHypertension (HTN) is a well known risk factor for atherosclerosis and peripheral arterial disease (PAD). PAD affects more than 250 million people globally and is associated with worse clinical outcomes. Although multiple studies have been performed to evaluate treatment of HTN in patients with PAD, blood pressure management in this high-risk cohort remains poor.Recent findingsThere has been conflicting evidence regarding blood pressure goals in PAD with some recent studies showing adverse outcomes with low blood pressure in this patient population. Current guidelines, however, continue to recommend treatment goals in PAD patients similar to patients without PAD. To date, no single antihypertensive drug class has shown a clear benefit in PAD population over other antihypertensive drug classes.SummaryProspective randomized trials enrolling PAD patients are required that can shed light on optimum blood pressure target and also distinguish between different antihypertensive drugs in terms of reducing adverse outcomes.

District Level Variation in Hypertension Epidemiology in India and Influence of Social Determinants: National Family Health Survey-5

“…In Europe hypertension prevalence is significantly greater in less developed countries of Central and Eastern Europe, 13 while in Asia the prevalence of hypertension is significantly lower in high income countries of Eastern Asia and high in Central and Southern Asian countries. 21 Positive association of hypertension in India with better development suggests that the risk factor transition that happens with social development has not yet occurred in India. 23 There is, on the other hand, evidence that at an individual level, hypertension may be more among illiterate rural and slum-dwelling populations, 23,24 and there is a significant association of low socioeconomic and educational status with greater cardiovascular mortality.…”

Variante da Subunidade Beta 3 da Proteína G ( GNB3 ) Está Associada a Alterações Bioquímicas em Pacientes Brasileiros com Hipertensão

“…Afeta vários órgãos-alvo e pode levar a morte súbita, acidente vascular cerebral, doença arterial periférica, insuficiência cardíaca, infarto agudo do miocárdio e doença renal crônica. 1 , 2 …”

“…It affects several target organs are and can lead to sudden death, stroke, peripheral arterial disease, heart failure, acute myocardial infarction, and chronic kidney disease. 1 , 2 …”

“…Afeta vários órgãos-alvo e pode levar a morte súbita, acidente vascular cerebral, doença arterial periférica, insuficiência cardíaca, infarto agudo do miocárdio e doença renal crônica. 1,2 A regulação fisiológica da pressão arterial e as alterações fisiopatológicas que levam à hipertensão arterial têm um componente genético. Pressupõe-se que 30% a 50% da variabilidade interindividual da pressão arterial pode ser estipulada geneticamente.…”

Factors associated with non-adherence to angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in older patients with peripheral arterial disease

“…It represents a strong risk factor for major adverse cardiac events (myocardial infarction (MI), stroke, cardiovascular (CV) death) and major adverse limb events (acute limb ischemia, critical limb ischemia, major amputations). Smoking, diabetes mellitus, dyslipidaemia, arterial hypertension, and chronic kidney disease are major modifiable risk factors of PAD ( Bonaca and Creager, 2015 ; Firnhaber and Powell, 2019 ; Bevan and White Solaru, 2020 ; Criqui et al, 2021 ; Gupta and Patel, 2022 ). Conservative treatment of PAD includes smoking cessation, exercise training in patients with intermittent claudication and administration of secondary preventive medications: statins, antiplatelet agents and antihypertensive medications.…”