The peripheral circulation and treatment of hyperlipoproteinemias

Forty patients with hyperlipoproteinemia were followed 4-9.3 years by non-invasive tests of their lower extremity circulation. Twenty-eight patients were treated by diet and/or drugs, and 12 patients were controls. Although all patients had abnormal non-invasive tests, only 15 patients had intermittent claudication. Seven patients had improved circulation tests while 13 showed a deterioration in the tests; 20 patients had no changes. The patients who showed improvement in tests had the highest incidence of intermittent claudication and the lowest average ankle to brachial artery systolic blood pressure index. Although treatment patients had a significant decrease in total cholesterol, triglycerides, and VLDL, no significant differences were found when the results of the circulation tests were analyzed according to treatment or control status of the patients, to abnormal lipid patterns, or, ignoring treatment status, to a decrease in lipids. The patients who showed a deterioration in tests had a significantly higher total cholesterol level at the beginning of, but not during, the study and did not significantly decrease their triglycerides. No significant changes occurred in HDL, LDL, or VLDL. This study presents a methodology for the long-term, non-invasive assessment of peripheral arterial disease and a pilot study for its application. Despite the small number of patients studied, the failure to demonstrate benefit would discourage a larger clinical trial of this treatment protocol.