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 .
Sexual function, satisfaction, and association of erectile dysfunction with cardiovascular disease and risk factors in cardiovascular high-risk patients: substudy of the ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNT Study in ACE-IN
BACKGROUND Erectile dysfunction ( ED ) is a common disorder in middle-aged men and is significantly influenced by cardiovascular risk factors ( CVRFs ) and cardiovascular disease . The sub study of the ONTARGET/TRANSCEND trials evaluates the relationship of erectile function to baseline characteristics and current treatment in cardiovascular high-risk patients who have been enrolled in these trials . The effects of treatment with telmisartan and ramipril , alone or in combination , including a telmisartan versus placebo arm will be determined prospect ively during a follow-up of 4 years . METHODS One thous and three hundred fifty-seven patients were evaluated in 13 countries at baseline , 2 years , and 4 years , with ED determined using the ED score of the Cologne Male Survey ( Kölner [ Cologne ] Evaluation of Erectile Dysfunction ) and the 5-item International Index of Erectile Function . Erectile dysfunction scores were related to CVRF and the use of cardiovascular drugs . RESULTS Prevalence of ED was 50.7 % ( Kölner [ Cologne ] Evaluation of Erectile Dysfunction ) and 54.3 % ( 5-item International Index of Erectile Function ) , respectively , with a decline of sexual activity after the diagnosis of cardiovascular disease . In multivariate analysis , diabetes mellitus ( P < .00001 ) , stroke ( P = .00026 ) , pelvic surgery ( P = .025 ) , and age of > 65 years ( P < .00001 ) correlated with the degree of ED . No significant associations were observed for cholesterol levels , hypertension , and smoking status as well as current treatment with angiotensin-converting enzyme inhibitors , angiotensin I antagonists , diuretics , beta-blockers , or calcium-channel blockers . CONCLUSIONS The ONTARGET/TRANSCEND-ED sub study shows a significant influence of cardiovascular disease on erectile function . In contrast to prior smaller studies , drug therapy and CVRF seem to play a minor role in cardiovascular high-risk patients . Follow-up data will provide information whether angiotensin-converting enzyme inhibitors , angiotensin I antagonists , or a combination thereof are able to improve erectile function
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 .