Pharmacological interventions for peripheral artery disease.
Peripheral arterial disease (PAD) encompasses the vascular diseases caused primarily by atherosclerosis and thromboembolic pathophysiological processes that alter the normal structure and function of the aorta, its visceral arterial branches and the arteries of the upper and lower extremities. PAD is associated with an increased risk for cardiovascular morbidity and mortality. The goals for pharmacological therapy in PAD should focus on reducing cardiovascular risk, improving walking distance and preventing critical limb ischaemia. Exercise training plays a key role in the therapeutic assessment, as well stopping smoking. Antiplatelet therapy (aspirin) should be given to every PAD patient if there are no contraindications. Neither their combination nor anticoagulant therapy has shown additional benefit in PAD patients. Several pharmacological agents have been developed to improve the functional state of the claudicant and to relieve the symptoms. Many studied drugs have shown either no, a small or a potential benefit. With future development of new drugs for PAD, there is an absolute need for very strict well-designed protocols in order to evaluate the claudication distance, the progression of the disease and the reduction in cardiovascular morbidity and mortality. New developments should focus on improvement of endothelial function, vascular repair and enhancement of collateral circulation.
Duprez
Daniel A
DA
University of Minnesota, Cardiovascular Division, Medical School, VCRC-Room 270, Minneapolis, MN 55455, USA. dupre007@umn.edu
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D005081:Exercise Therapy; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007383:Intermittent Claudication / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D008019:Life Style; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016540:Smoking Cessation; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors