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 .
Effects of ketanserin on blood pressure, peripheral circulation and haemocoagulative parameters in essential hypertensives with or without arteriosclerosis obliterans of the lower limbs.
Ketanserin is a new strong antiserotoninergic drug that , unlike the previous ones , is selective for 5-hydroxytryptamine receptors . This drug has been employed successfully in the treatment of arterial hypertension and of some peripheral vascular diseases . The authors are carrying out a trial on medium term treatment with ketanserin ( K ) or propranolol ( P ) in comparison with placebo , to evaluate their effects on blood pressure , haemocoagulative parameters and peripheral circulation . The trial is a double-blind cross-over r and om trial on subjects with mild or moderate hypertension . Until now 13 patients have ended the study ; six of them are suffering from arteriosclerosis obliterans of the lower limbs at 1st or 2nd stage according to Fontaine . Both propranolol and ketanserin significantly reduced the blood pressure , although the decrease in systolic blood pressure was more evident after propranolol .  Heart rate diminished significantly only after propranolol administration . The noninvasive , intermittent ( every 30 min ) monitoring of blood pressure showed a significant 24-hour reduction of blood pressure after administration of propranolol or ketanserin without significant changes of circadian behaviour of the blood pressure . After administration of ketanserin a slight improvement in peripheral circulation was demonstrated , evaluated by using strain-gauge plethysmography . As regards the results obtained for platelet function and other haemocoagulative parameters examined , adenosine diphosphate-induced platelet aggregation , adenosine diphosphate slope , collagen lag period , antithrombin III biological activity , and serum fibrinogen did not show noticeable modifications after treatment , while beta-thromboglobulin levels decreased slightly after ketanserin administration
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 .