Peripheral arterial disease: epidemiology and drug therapy.
Lower-extremity peripheral arterial disease (PAD) is common among older men and women, affecting 20%-30% of older men and women in general medicine practices. History and physical examination are insensitive measures of PAD. However, PAD can be noninvasively and reliably diagnosed in the office with the ankle-brachial index, a ratio of Doppler-recorded systolic pressures in the lower and upper extremities. An ankle-brachial index less than 0.90, consistent with PAD, is associated with increased risk of cardiovascular morbidity and mortality in addition to functional impairment. Drug therapy in PAD is directed at reducing the increased risk of cardiovascular events and improving walking impairment. Intensive atherosclerotic risk factor intervention and angiotensin-converting enzyme inhibitors are recommended for reducing cardiovascular event rates in persons with PAD. Components of an effective exercise intervention and drug therapy to reduce claudication-related walking impairment in PAD are also reviewed.
McDermott
Mary McGrae
MM
Feinberg School of Medicine at Northwestern University, Chicago, IL 60611, USA.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D002986:Clinical Trials as Topic; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors