Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .
Compliance to multiple interventions in a high risk population.
PURPOSE Assess compliance with study medications and examine reasons for noncompliance .  Individuals with peripheral arterial disease present the clinician with a unique combination of symptoms and therapeutic needs ; the treatment of this population has not been adequately studied . METHODS The Arterial Disease Multiple Intervention Trial was a r and omized double-blind placebo-controlled trial that r and omized 468 participants to a combination of antioxidants , niacin and warfarin or matching placebos . Men and women ( mean age 65 yrs ) with peripheral arterial disease and low-density lipoprotein ( LDL ) < 190 mg/dl were enrolled and followed for one year . Compliance to the study medications was measured by pill count for each medication . An overall measure of compliance was determined by combining pill counts from all study visits . RESULTS Mean overall pill counts ranged from 88 to 94 % in the eight treatment groups . No statistically significant differences were found in mean pill counts over time or between active and placebo groups . History of coronary artery disease and number of follow-up visits were associated with higher overall pill counts while low compliance during screening was associated with lower counts during follow-up . Participants with an overall mean pill count < 80 % had more adverse events compared to those with a higher count . Side effects were reported as the reason for missing pills significantly more often in the active versus placebo niacin group . CONCLUSIONS Individuals with peripheral arterial disease were able to comply with the complex drug regimen . The ability of this drug combination to reduce cardiovascular events and improve quality of life warrants study
Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .