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 .
Baseline characteristics of participants in the Appropriate Blood Pressure Control in Diabetes trial.
The ABCD ( Appropriate Blood Pressure Control in Diabetes ) trial is a large , prospect i ve , r and omized clinical trial design ed to compare the effects of intensive with moderate blood pressure control on the prevention and progression of diabetic nephropathy , retinopathy , cardiovascular disease , and neuropathy in non-insulin-dependent diabetes ( NIDDM ) . The secondary objective is to determine equivalency of the effects of a calcium channel blocker ( nisoldipine ) and of an angiotensin-converting enzyme inhibitor ( enalapril ) as a first-line antihypertensive agent in the prevention and /or progression of these diabetic vascular complications . The study consists of two study population s : a hypertensive one ( diastolic blood pressure of > or = 90.0 mm Hg at the time of r and omization ) and a normotensive one ( diastolic blood pressure of 80.0 - 89.0 mm Hg at the time of r and omization ) . A total of 950 men and women aged 40 - 74 years were r and omized and are being followed for 5 years at a single center . There were 470 r and omized participants in the hypertensive population and 480 r and omized participants in the normotensive population . This report summarizes the demographic , biochemical , and clinical characteristics of the r and omized patients at the time of entry into the trial and evaluates the balance between the treatment groups within each population
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 .