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 .
A comparison of low versus standard dose pravastatin therapy for the prevention of cardiovascular events in the elderly: the pravastatin anti-atherosclerosis trial in the elderly (PATE).
Treatment with low drug doses is generally recommended in the elderly . However , the efficacy of low dose 3-hydroxy-3-methylglutaryl coenzyme A ( HMG CoA ) reductase inhibitor treatment in elderly hypercholesterolemic patients has never been examined . Therefore , we compared the effect of low-dose with st and ard dose pravastatin , an HMG CoA reductase inhibitor , on the incidence of cardiovascular events ( CVEs ) in elderly patients with hypercholesterolemia in a r and omized prospect i ve trial . Subjects aged > or = 60 years ( 73 + /- 6 years ) with serum total cholesterol ( TC ) levels of 220 - 280 mg/dL were r and omized to the low-dose ( groupL , 5 mg/day ; n=334 ) or st and ard dose ( groupS , 10 - 20mg/day ; n= 331 ) . Baseline TC levels were similar in the 2 groups ( 253 + /-15 mg/dL ) . Patients were followed for 3 - 5 years ( mean 3.9 years ) . TC levels decreased from baseline by 11 - 13 % in group L and by 15 - 17 % in groupS. TC levels at 1 year in S and L group were 209 + /- 2 mg/ dL ( 16 + /- 1 % decrease ) and 221+/- 2 mg/dL ( 12 + /- 1 % decrease ) , respectively . Forty two and 29 CVEs occurred in group L and S , respectively . The incidence of CVEs was significantly lower in group S than in group L ( P = 0.046 , generalized Wilcoxon test ; P = 0.096 , log-rank test ) . The risk ratio for group S compared with group L was 0.674 ( 95 % confidence interval : 0.423 - 1.074 ) . Subgroup analyses suggested that the difference in the incidence of CVEs between the 2 groups was more clear in subjects without diabetes mellitus , with TC levels of < 253 mg/dL , and with TG levels of > or = 133 mg/dL. The incidence of CVEs in group S was significantly lower than that in group L in subjects without both diabetes mellitus and previous cardiovascular disease ( P = 0.026 , generalized Wilcoxon test ; P = 0.032 , log rank test ) . These findings suggest that st and ard-dose pravastatin ( 10 - 20 mg/day ) is more effective in reducing the incidence of CVEs in the elderly than low dose pravastatin ( 5 mg/ day ) , especially in nondiabetic elderly patients with mild hypercholesterolemia or previous cardiovascular disease
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 .