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Peripheral vascular disease and hypertension: a forgotten association?

A Makin1, G Y Lip, S Silverman

  • 1University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.

Journal of Human Hypertension
|July 21, 2001
PubMed

Insights

Peripheral vascular disease (PVD) and hypertension significantly increase cardiovascular risks. More research is needed to determine if blood pressure reduction lowers PVD incidence.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Hypertension Research

Background:

  • Peripheral vascular disease (PVD) is linked to substantial cardiovascular morbidity and mortality.
  • Intermittent claudication, a common PVD symptom, predicts a threefold increase in cardiovascular death and a two-to-fivefold increase in all-cause mortality.
  • Hypertension is a prevalent risk factor for vascular disorders, including PVD, affecting 2-5% of hypertensive individuals and co-existing in 35-55% of PVD patients.

Purpose of the Study:

  • To highlight the significant overlap and synergistic risks between hypertension and PVD.
  • To underscore the lack of evidence from major antihypertensive trials on PVD incidence reduction.
  • To establish the need for outcome studies investigating the effect of blood pressure reduction on PVD incidence.

Main Methods:

  • Review of epidemiological associations between hypertension and PVD.
  • Analysis of the contribution of hypertension to atherosclerosis and atherothrombotic states.
  • Identification of gaps in current antihypertensive treatment trial data regarding PVD outcomes.

Main Results:

  • Hypertension exacerbates cardiovascular risks in PVD patients, increasing risks of myocardial infarction and stroke.
  • Hypertension contributes to the pathogenesis of atherosclerosis, the underlying cause of PVD.
  • Both hypertension and PVD are associated with hemostatic and lipid abnormalities, promoting an atherothrombotic state.

Conclusions:

  • The combined presence of hypertension and PVD significantly elevates cardiovascular and all-cause mortality.
  • Hypertension plays a critical role in the development and progression of PVD through atherosclerotic mechanisms.
  • Further outcome studies are essential to ascertain if blood pressure management can mitigate PVD incidence.

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