Related Experiment Videos
Antihypertensive treatment in patients with peripheral vascular disease
1Department of Vascular Medicine, Cleveland Clinic Foundation, OH 44195.
Insights
Treating hypertension in patients with peripheral vascular disease involves general guidelines plus specific goals like improving intermittent claudication. Nonpharmacologic therapies are ideal for managing blood pressure and associated conditions.
Area of Science:
- Cardiology
- Vascular Medicine
- Hypertension Management
Background:
- Hypertension management in patients with peripheral vascular disease (PVD) requires specific considerations.
- PVD encompasses atherosclerosis or aneurysms of the aorta or peripheral arteries.
Purpose of the Study:
- To review current information on treating hypertension in patients with PVD.
- To outline specific treatment goals and strategies for this patient population.
Main Methods:
- Literature review of studies and guidelines concerning hypertension and PVD.
- Analysis of nonpharmacologic and pharmacologic treatment options.
Main Results:
- General hypertension guidelines apply, with added goals for PVD.
- Nonpharmacologic interventions (weight management, diet, exercise) improve blood pressure, lipids, glucose control, and claudication symptoms.
- Smoking cessation is crucial.
Conclusions:
- Integrated management of hypertension and PVD is essential.
- Nonpharmacologic strategies are primary for improving outcomes in hypertensive patients with PVD.
- Beta blockers are recommended for patients with aneurysms.
Background:
Some specific treatment goals are indicated for patients with hypertension complicated by peripheral vascular disease.
Objective:
To review the available information about treating hypertension in patients with atherosclerosis or aneurysms of the aorta or peripheral arteries.
Summary:
Patients with peripheral vascular disease and hypertension should be treated according to the general guidelines for all patients with hypertension. However, specific treatment goals include improvement or stabilization of intermittent claudication and associated conditions such as coronary artery disease, hyperlipidemia, and diabetes mellitus. The ideal therapy for most of these conditions is nonpharmacologic: achievement of ideal body weight, a diet low in cholesterol, saturated fat, and salt, and a regular exercise program will improve blood pressure control, lipid values, blood glucose control, insulin sensitivity, symptoms of intermittent claudication, and long-term survival. Patients who smoke should stop. Patients with aneurysms should receive beta blockers.
Conclusions:
Antihypertensive therapy in patients with peripheral vascular disease should be part of a general program of risk-factor reduction.