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 .
Lowering of HDL2b by probucol partly explains the failure of the drug to affect femoral atherosclerosis in subjects with hypercholesterolemia. A Probucol Quantitative Regression Swedish Trial (PQRST) Report.
The aim of the Probucol  Quantitative Regression Swedish Trial ( PQRST ) ( n = 303 ) was to investigate whether probucol ( 0.5 g BID ) added to diet and cholestyramine ( 8 g BID ) could retard progression or induce regression of femoral atherosclerosis in hypercholesterolemic ( > 6.86 mmol/L ) subjects .  Probucol did not induce regression over the 3-year trial period as estimated by change in lumen volume on quantitative arteriography of a 20-cm segment of the femoral artery . In this report we studied in a representative subgroup ( n = 72 ) whether the reduction in HDL concentrations induced by probucol could explain the failure of the drug to be effective . We analyzed the effects of treatment on HDL particle size subclasses . Probucol lowered the relative level of HDL2b , comprising the largest HDL particles , by 53 % and the protein concentration of HDL2b by 67 % . The protein reduction in HDL was mainly confined to the apolipoprotein A-I moiety . The change in lumen volume correlated significantly with change in HDL , ie , HDL cholesterol ( r = .34 , P < .01 ) , HDL2 cholesterol ( r = .37 , P < .01 ) , HDL2b protein ( r = .44 , P < .001 ) , and the relative HDL2b value ( r = .51 , P < .001 ) . The corresponding values for relative HDL2b , distribution calculated on the active ( n = 35 ) and placebo ( n = 37 ) groups separately were also significant ( r = .39 and .32 , respectively ; both P < .05 ) . The correlation between drug-induced change in the relative HDL2b concentration and change in atherosclerosis was independent of the alteration in triglyceride concentration and could not be explained by treatment interaction . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .