Treatment of hypertension in peripheral arterial disease

Lane, Deirdre A.; Lip, Gregory Y.H.

doi:10.1002/14651858.cd003075.pub2

Cited by 18 publications

(18 citation statements)

References 67 publications

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“…Omega-2 fatty acids and nicotinamide have no positive eff ect on morbidity or mortality. Hypertensive patients should have a target blood pressure below 140/90 mmHg [17]. ACE-inhibitors improve walking distance [18].…”

Section: Conservative Therapy General Aspectsmentioning

confidence: 99%

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Lawall

Huppert

Espinola‐Klein

et al. 2017

Vasa

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Summary:The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease. A systematic literature review and formal consensus fi nding process, including delegated members of 22 medical societies and two patient self-support organisations were conducted and supervised by the Association of Scientifi c Medical Societies in Germany, AWMF. Three levels of recommendation were defi ned, A = "is recommended/ indicated", B = "should be considered", C = "may be considered", means agreement of expert opinions due to lack of evidence. Altogether 294 articles, including 34 systematic reviews and 98 RCTs have been analysed. The key diagnostic tools and treatment basics have been defi ned. In patients with intermittent claudication endovascular and/or surgical techniques are treatment options depending on appropriate individual morphology and patient preference. In critical limb ischaemia, revascularisation without delay by means of the most appropriate technique is key. If possible and reasonable, endovascular procedures should be applied fi rst. The TASC classifi cation is no longer recommended as the base of therapeutic decision process due to advances in endovascular techniques and new crural therapeutic options. Limited new data on rehabilitation and follow-up therapies have been integrated. The article summarises major new aspects of PAD treatment from the updated German Guidelines for Diagnosis and Treatment of PAD. Limited scientifi c evidence still calls for randomised clinical trials to close the present gap of evidence.Keywords: Peripheral artery disease, diagnosis, treatment, update, guideline update fi cation [2] has been the basis of the therapeutic decision process for the last decade. Its four types A-B-C-D classify peripheral atherosclerotic vascular lesions of increasing length and complexity. According to TASC, type A and B lesions were recommended to be treated endovascular-fi rst, type C and D lesions were typically fi rst addressed for surgical repair. With increasing experience of intervention and advanced stent technologies, such as drug eluted and covered stent grafts of increasing lengths, bifurcational stents, and covered angioplasty catheters, the endovascular procedures recently have become increasingly successful. Patients request non-surgical procedures as an alternative approach without risk of narcosis and lower invasive character. A renunciation from the TASC guided approach has become the consequence of the scientifi c literature evaluation.

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Section: Conservative Therapy General Aspectsmentioning

confidence: 99%

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Lawall

Huppert

Espinola‐Klein

et al. 2017

Vasa

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“…47 In patients with stroke/TIA, clopidogrel was as effective as aspirin in reduction of vascular death (including PAD). 48 A systematic review found no evidence that ␤-blockers should be avoided in patients with PAD, 49 but they should be avoided in secondary prevention after TIA/stroke because they increase blood pressure variability. 41 Fifth, asymptomatic PAD is associated with worse limb function, possibly hampering poststroke recovery.…”

Section: Banerjee Et Al Peripheral Artery Disease and Ischemic Strokementioning

confidence: 99%

“…У паци-ентов с инсультом/ТИА применение клопидогрела было таким же эффективным, как и аспирина в отношении снижения летальности от сосудистых заболеваний (в т. ч. ЗПА) [48]. При проведении систематического обзора не обнаружили доказательств того, что следует избегать назначения β-адреноблокаторов пациентам с ЗПА [49], однако следует избегать применения их в целях вторичной профилактики после ТИА/инсульта, поскольку они увеличивают колебания уровня арте-риального давления [41].…”

Section: клиническое значение зпа в первичной профилактике инсультаunclassified

Associations Between Peripheral Artery Disease and Ischemic Stroke

Banerjee

Fowkes²,

Rothwell³

2010

Stroke

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Background and Purpose-Although peripheral artery disease (PAD) has a particularly poor prognosis compared with vascular disease in other territories, little attention is paid to its epidemiology, treatment, and prevention. Despite the high prevalence of PAD in patients with stroke, and of stroke in patients with PAD, PAD is omitted from all guidelines for treatment, prevention, and rehabilitation of stroke, although coronary artery disease risk is considered. Therefore, routine PAD screening is seldom undertaken and so disease is probably often missed. Summary of Review-This review evaluates epidemiology of PAD in patients with stroke and of stroke in patients with PAD. The role of the ankle-brachial pressure index; imaging and novel markers in risk prediction of PAD in patients with stroke; and treatment and prevention of PAD are reviewed. Conclusions-In

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“…13,29 The evidence for a decrease in CV events after using antihypertensive agents is less well documented in patients with PAD. 30 …”

Section: Disadvantages Of Screeningmentioning

confidence: 99%

Screening for Peripheral Arterial Disease Using the Ankle-Brachial Index in Diabetic and Other High-Risk Patients

2015

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Treatment of hypertension in peripheral arterial disease

Cited by 18 publications

References 67 publications

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Associations Between Peripheral Artery Disease and Ischemic Stroke

Screening for Peripheral Arterial Disease Using the Ankle-Brachial Index in Diabetic and Other High-Risk Patients

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