Medical therapy for peripheral arterial disease

Abstract

Peripheral arterial disease (PAD) is underdiagnosed, undertreated, and increasing in prevalence. Continued advances in understanding atherosclerosis, pathophysiology of vascular disease and risk factor modification emphasize the importance of a complete medical regimen. With the recently changed guidelines for PAD suggesting screening patients at an earlier age and the known benefits of using preventive therapies for PAD, this is the perfect time to review recent information and research on medical therapy for PAD, both for symptomatic patients and for secondary prevention. PAD is a manifestation of systemic atherosclerosis. With the recent update of the ACC/AHA guidelines for the management of PAD, risk factor modification continues to be a major focus. Smoking is one of the most important modifiable risk factors in patients with PAD. New recommendations and therapeutic options exist for assisting patients in smoking cessation. Additionally, new evidence continues to support controlling hypertension, controlling lipids and use of antiplatelet agents. Evidence continues to evolve about the evidence of exercise therapy in symptomatic and asymptomatic PAD. PAD is associated with increased risk of cardiovascular morbidity and mortality. Medical therapy is targeted toward systemic atherosclerosis and risk factor modification. Exercise therapy is the most studied and validated therapy for symptomatic peripheral arterial disease.