However , lack of data specifically examining outcomes in PAD patients should not detract from the overwhelming evidence on the benefit of treating hypertension and lowering blood pressure
BACKGROUND Peripheral arterial disease ( PAD ) causes considerable morbidity and mortality .
Hypertension is a risk factor for PAD .
Treatment for hypertension must be compatible with the symptoms of PAD .
Controversy regarding the effects of beta-adrenoreceptor blockade for hypertension in patients with PAD has led many physicians to stop prescribing beta-adrenoreceptor blockers .
Little is known about the effects of other classes of anti-hypertensive drugs in the presence of PAD .
This is the second up date of a Cochrane review first published in 2003 .
OBJECTIVES To determine the effects of anti-hypertensive drugs in patients with both raised blood pressure and symptomatic PAD in terms of the rate of cardiovascular events and death , symptoms of claudication and critical leg ischaemia , and progression of atherosclerotic PAD as measured by ankle brachial index ( ABI ) changes and the need for revascularisation ( reconstructive surgery or angioplasty ) or amputation .
The effects of acebutolol and metoprolol on walking distances and distal blood pressure in hypertensive patients with intermittent claudication.
The effects of acebutolol ( with intrinsic sympathomimetic activity ( ISA ] and metoprolol ( without ISA ) on arm blood pressure , ankle systolic blood pressure , claudication distances ( CD ) and maximal walking distances ( MWD ) were compared in patients with essential hypertension and intermittent claudication . Fourteen patients participated in a long-term , open , r and omized cross-over study . After r and omization the patients received either acebutolol , 200 mg b.i.d . , or metoprolol , 100 mg b.i.d . After eight weeks the drugs were shifted and after another eight weeks they were withdrawn . Arm and ankle blood pressure , CD and MWD were determined before r and omization and after 4 , 8 , 12 and 16 weeks , and again 4 - 6 weeks after withdrawal of the drugs . The arm blood pressure was reduced by 20/13 mmHg after acebutolol and by 22/21 mmHg after metoprolol . In spite of a significant decrease in arm blood pressure there were no significant changes in ankle blood pressure , CD or MWD after the two drugs . After withdrawal of the drugs and after the arm blood pressure had returned to the control value no significant changes were seen in CD , MWD or ankle blood pressure . It is concluded that beta-blockers have no deleterious effect on CD , MWD or ankle blood pressure in patients with hypertension and intermittent claudication . No effect of ISA was demonstrated
However , lack of data specifically examining outcomes in PAD patients should not detract from the overwhelming evidence on the benefit of treating hypertension and lowering blood pressure
BACKGROUND Peripheral arterial disease ( PAD ) causes considerable morbidity and mortality .
Hypertension is a risk factor for PAD .
Treatment for hypertension must be compatible with the symptoms of PAD .
Controversy regarding the effects of beta-adrenoreceptor blockade for hypertension in patients with PAD has led many physicians to stop prescribing beta-adrenoreceptor blockers .
Little is known about the effects of other classes of anti-hypertensive drugs in the presence of PAD .
This is the second up date of a Cochrane review first published in 2003 .
OBJECTIVES To determine the effects of anti-hypertensive drugs in patients with both raised blood pressure and symptomatic PAD in terms of the rate of cardiovascular events and death , symptoms of claudication and critical leg ischaemia , and progression of atherosclerotic PAD as measured by ankle brachial index ( ABI ) changes and the need for revascularisation ( reconstructive surgery or angioplasty ) or amputation .