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 .
The effects of tertatolol on lipid profile.
Tertatolol is a noncardioselective beta-blocker without intrinsic sympathomimetic activity . In a preliminary 3-month open study , it was shown that T was devoid of any atherogenic effect since HDL-cholesterol ( HDL-C ) and apoprotein levels did not change for 3 months of therapy . To investigate the long-term effects of tertatolol on the lipid profile and its safety in hypertensive patients with peripheral arterial disease ( PAD ) , a 9-month , r and omized , double-blind , parallel group study was carried out in 40 patients .  Tertatolol 5 mg once daily was compared with metoprolol 200 mg once daily . If BP was not controlled after 2 months , a vasodilatator agent , dihydralazine , was added at the lowest dose required to control BP ( diastolic BP < 90 mm Hg ) . Lipoprotein fractions and apoproteins were assayed before ( M0 ) and after 2 , 6 and 9 months of therapy . At the same occasions , peripheral arterial disease ( PAD ) was evaluated on exercise tests carried out on a treadmill and on the regional blood flow measured in the ankle arteries by the Doppler technique . Four patients were not eligible for analysis . In the tertatolol group , 1 patient with a normal BP , and 2 patients who dropped out , 1 because of persistent nausea and 1 because of personal reasons . In the metoprolol group , 1 patient refused to take dihydralazine . In the 35 fully documented patients , BP control was achieved in both groups . The mean reductions in supine systolic/diastolic BP were 31.4/14.6 and 34.7/17.1 mm Hg in the tertatolol and metoprolol groups , respectively . ( 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 .