Treatment of Intermittent Claudication due to Peripheral Arterial Disease

Abstract

Peripheral arterial disease may cause intermittent claudication which is pain or weakness with walking that is relieved with rest [1]. Patients with intermittent claudication should be treated with optimal medical therapy to reduce cardiovascular death, nonfatal myocardial infarction, and stroke and also to improve exercise time until intermittent claudication [1]. Optimal medical therapy to reduce cardiovascular events and mortality in patients with peripheral arterial disease include smoking cessation programs [1], treatment of hypertension [1-3], treatment of hypercholesterolemia [1,4], treatment of diabetes mellitus [1,5], antiplatelet drug therapy [1,6-8], treatment with an angiotensin-converting enzyme inhibitor [1,3], treatment with high-dose statins [1,4,9], and treatment with beta blockers if indicated in patients with mild-to moderate peripheral arterial disease [1,10]. Vorapaxar [11] has recently been approved by the United States Food and Drug Administration to treat patients with peripheral arterial disease receiving aspirin or clopidogrel to reduce the need for peripheral artery revascularization. This drug should not be used in patients with a history of stroke or transient ischemic attack or bleeding in the head.