Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .
The MRC/BHF Heart Protection Study: preliminary results.
The Heart Protection Study ( HPS ) , with over 20,500 subjects , is the largest trial of statin therapy ever conducted . It provides important and definitive new information on women , the elderly , diabetics , and people with low baseline cholesterol pre-treatment and those with prior occlusive non-coronary vascular disease . It is a prospect i ve double blind r and omised controlled trial with a 2 x 2 factorial design investigating prolonged use ( > 5 years ) of simvastatin 40 mg and a cocktail of antioxidant vitamins ( 650 mg vitamin E , 250 mg vitamin C and 20 mg beta-carotene ) . The HPS specifically included patients with high risk for coronary heart disease ( CHD ) but characteristics that excluded them from participation in previous statin trials .  Simvastatin 40 mg treatment showed benefit across all patient groups regardless of age , gender or baseline cholesterol value and proved safe and well tolerated . Results show a 12 % reduction in total mortality , a 17 % reduction in vascular mortality , a 24 % reduction in CHD events , a 27 % reduction in all strokes and a 16 % reduction in non-coronary revascularisations . Among high-risk patients in this western population ( with a minimum total cholesterol [ TC ] > or = 3.5 mmol/l at entry ) there appears to be no threshold cholesterol value below which statin therapy is not associated with benefit ; even among those with pre-treatment cholesterol levels below current national recommended targets . Over the 5.5 year study period patients and their doctors were encouraged to add an active non- study statin to the study regimen if they wished to do so . Thus the trial eventually had only two-thirds complying with the original intention-to-treat design . Nevertheless , results were highly significant for the study statin -- simvastatin 40 mg once daily . Preliminary results of the HPS are negative for the antioxidant vitamin cocktail but provide reassurance that vitamins do no harm
Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .