Document Detail


Management of hypertension in peripheral arterial disease: does the choice of drugs matter?
MedLine Citation:
PMID:  18375152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cardiovascular disease and death are major life-threatening problems in patients with atheromatous peripheral arterial disease (PAD). This review focuses on management of hypertension in the context of cardiovascular risk in patients with PAD. PAD is underdiagnosed and hypertension in PAD is often poorly managed. Current evidence supports a low threshold for blood pressure treatment in PAD and intensive blood pressure control to reduce the high risk of cardiovascular disease and death in patients with PAD. Optimal treatment targets should be <140/85 mmHg, with the lower target of <130/80 mmHg in the presence of diabetes mellitus or chronic renal disease. Class-specific selection of anti-hypertensive treatments in PAD should be based on caution in relation to co-existing renovascular disease and indications and contraindications based on other significant co-morbidity. There is a pressing need for primary end-point studies targeted specifically at patients with PAD. In particular, prospective studies in PAD are needed to obtain evidence for benefits from specific blood pressure classes of treatment as well as the optimal blood pressure treatment target level. These studies should consider impact in PAD of different demographic, risk factor, and co-morbidity profiles.
Authors:
D R J Singer; A Kite
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2008-04-02
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  35     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  701-8     Citation Subset:  IM    
Affiliation:
Clinical Sciences Research Institute, Warwick Medical School, University of Warwick, United Kingdom. mdscaf@warwick.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use*
Blood Pressure*
Calcium Channel Blockers / therapeutic use
Cardiovascular Diseases / etiology,  physiopathology,  prevention & control*
Evidence-Based Medicine
Humans
Hypertension / complications,  drug therapy*,  etiology,  physiopathology
Life Style
Patient Selection*
Peripheral Vascular Diseases / complications*,  drug therapy,  physiopathology
Practice Guidelines as Topic
Prevalence
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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