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 .
A new trial of the efficacy, tolerability, and safety of angiotensin-converting enzyme inhibition in mild systemic hypertension with concomitant diseases and therapies. Perindopril Therapeutic Safety Study Group (PUTS).
A multicenter , double-blind , r and omized , and placebo-controlled trial , the Perindopril Therapeutic Safety Study ( PUTS ) , was design ed to assess the interaction between angiotensin-converting enzyme ( ACE ) inhibition and the diseases and therapies commonly found associated with mild hypertension . A total of 480 male and female patients aged 30 - 70 years with a diastolic pressure of 90 - 104 mm Hg were included after a 3-week placebo run-in if they satisfied st and ard criteria for any of the following : hyperlipidemia , type II diabetes , ischemic heart disease , cardiac arrhythmia , peripheral arterial occlusive disease , nephropathy with proteinuria , chronic obstructive lung disease or treatment with nonsteroidal anti-inflammatory drugs ( NSAIDs ) . At the end of the placebo run-in period , patients were r and omly assigned to either placebo or perindopril 4 mg once daily . A total of 460 patients completed the 6-week double-blind phase , comprising 3 assessment s at 1 , 3 , and 6 weeks . In this report , the principal results obtained in 5 disease groups ( hyperlipidemia , type II diabetes , ischemic heart disease , nephropathy with proteinuria , and NSAID treatment ) will be reported . A total of 269 patients belonging to one of the aforementioned 5 disease groups completed the double-blind phase of the study and were included for statistical evaluation . In the perindopril group , systolic and diastolic blood pressures decreased significantly more than in the placebo group , and a sitting diastolic blood pressure of 90 mm Hg was achieved in 65 % of patients in the perindopril group and 30 % of patients in the placebo group . The incidence of symptoms spontaneously reported by the patients was low : 2 patients of the perindopril group complained of cough . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .