[Lower limb arterial disease and renal artery stenosis].
Peripheral arterial disease (PAD) refers to the atherosclerotic involvement of non-coronary and extracranial arteries, including visceral arteries, the aorta and its branches and the arteries of the limbs. PAD usually refers exclusively to atherosclerosis of the limbs (in particular the lower limbs). Age, male sex, smoking and diabetes, as well as hypertension and dyslipidemia, are the most relevant risk factors for the development of PAD. PAD is frequently associated with coronary heart disease and stroke. PAD patients have increased risk of developing cardiovascular complications (coronary disease, stroke) and total and cardiovascular mortality, even after adjustment by conventional risk factors. Despite this PAD exhibit a worse control of risk factors. This opens up an important opportunity to optimize their control, which can result in an improvement of the prognosis of patients with PAD. Ischemic nephropathy includes a constellation of disorders that are frequently associated: hypertension, renal failure and renal artery stenosis (RAS). RAS risk factors are similar to those of PAD. Recent studies have shown that renal revascularization is not associated with improvement in blood pressure control, preservation of renal function or reduction of cardiovascular events in most patients. Therefore, revascularization should be reserved for selected cases on an individual basis. In all cases, a strict control of vascular risk factors should be attempted.
Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Departamento de Medicina y Cirugía, Universidad Rey Juan Carlos, Alcorcón, Madrid, España. Electronic address: cguijarro@fhalcorcon.es.
Carlos
C
Guijarro
Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Hospital Carlos III, Madrid, España.
José María
JM
Mostaza
Servicio de Endocrinología, Hospital Universitario Dr. Peset, Departamento de Medicina, Universitat de València, Valencia, España.
Antonio
A
Hernández-Mijares
D000367:Age Factors; D050197:Atherosclerosis / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors; D012737:Sex Factors