title: Do Medications Commonly Prescribed to Patients with Peripheral Arterial Disease Have an Effect on Nutritional Status? A Review of the Literature.
abstract: BACKGROUND
  Polypharmacy is common among patients with peripheral arterial disease (PAD) with a combination of medications used for risk-factor modification and medical management of the disease itself. Interaction between commonly prescribed medications and nutritional status has not previously been well described. This review aims to critically appraise evidence exploring associations between medications commonly prescribed to patients with PAD and nutritional status and provide recommendations for practice.
  
  
  METHODS
  A comprehensive literature search was conducted to locate studies relating to nutrient interactions among lipid-lowering, antihypertensive, antiplatelet, and oral hypoglycemic drug classes. Quality of the evidence was rated on the basis of recommendations by the National Health and Medical Research Council.
  
  
  RESULTS
  A total of 25 articles were identified as suitable and included in the review. No studies were specific to patients with PAD, and hence findings highlighting risk of ubiquinone (coenzyme Q10 [CoQ10]) depletion with lipid-lowering medications, zinc depletion with antihypertensive medications, and vitamin B12 depletion with oral hypoglycemic medications are extrapolated from heterogeneous groups of patients and healthy adults. The body of evidence ranged in quality from satisfactory to poor.
  
  
  CONCLUSIONS
  High-quality research is required to confirm the interactions suggested by the included studies in patients with PAD specifically. It is, however, recommended that patients with PAD that are long-term consumers of the selected medications are monitored for CoQ10, zinc, and vitamin B12 to facilitate early identification of deficiencies and initiation of treatment. Treatment may involve dietary intervention and/or supplementation.
authors.affiliation: Department of Nutrition and Dietetics, Flinders University, Bedford Park, South Australia.
authors.forename: Renee
authors.initials: R
authors.lastname: Fenton
authors.affiliation: Department of Pharmacy, Southern Adelaide Local Health Network, Bedford Park, South Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Brook-Barclay
authors.affiliation: Department of Vascular Surgery, Flinders University, Bedford Park, South Australia.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Delaney
authors.affiliation: Department of Vascular Surgery, Flinders University, Bedford Park, South Australia; Department of Vascular Surgery, Southern Adelaide Local Health Network, Bedford Park, South Australia.
authors.forename: J Ian
authors.initials: JI
authors.lastname: Spark
authors.affiliation: Department of Nutrition and Dietetics, Flinders University, Bedford Park, South Australia. Electronic address: michelle.miller@flinders.edu.au.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Miller
mesh_terms: D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000009:adverse effects*; D003677:Deficiency Diseases / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D009752:Nutritional Status / Q000187:drug effects*; D058729:Peripheral Arterial Disease / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D019338:Polypharmacy; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors