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 .
Effect of Felodipine on Regional Blood Supply and Collateral Vascular Resistance in Patients with Peripheral Arterial Occlusive Disease
This double-blinded , r and omized , placebo-controlled study was design ed to investigate the acute effect of felodipine on regional blood supply and collateral vascular resistance in patients with peripheral arterial occlusive disease ( PAOD ) . Thirty men with PAOD were treated with a single dose of 5 mg felodipine or placebo .  Systolic blood pressure ( SBP ) , Doppler ankle pressure ( DAP ) , calf blood flow ( CBF ) by venous occlusion plethysmography and calf transcutaneous oxygen tension ( tcpO2 ) were measured during a cycle ergometry . Felodipine reduced SBP significantly ( from 149 to 136 mmHg , p < 0.05 ) , while placebo did not . DAP increased slightly but not significantly in both groups . The pressure gradient between SBP and DAP fell significantly in the felodipine group ( 60 vs 39 mmHg , p < 0.01 ) but not in the placebo group ( 59 vs 56 mmHg ) . There was a trend for lower velocity in tcpO2 decrease during the stress test and higher velocity of tcpO2 increase during recovery from exercise in the felodipine group although the differences between both groups were not significant . In the felodipine group , CBF increased by 35.6 % ( p < 0.05 ) whereas it did not change in the placebo group . In conclusion , while lowering SBP , felodipine increased slightly , or at least maintained , the blood supply to the calves in PAOD patients , which probably results from reducing collateral vascular resistance
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 .