Key result
Current evidence fails to define optimal BP targets or specific antihypertensive classes for PAD patients.
Why the study?
Hypertension is a major risk factor for peripheral arterial disease, but blood pressure management in this high-risk population remains poor.
What is the optimal blood pressure target and antihypertensive drug class for patients with peripheral arterial disease?
What is the optimal blood pressure target and antihypertensive drug class for patients with peripheral arterial disease?
There is a lack of clear evidence regarding the optimal blood pressure target and preferred antihypertensive drug class for patients with peripheral arterial disease, highlighting the need for prospective randomized trials.
Evidence insufficient for BP targets or classes in PAD; leaves open optimal approach pending RCTs.
PURPOSE OF REVIEW: Hypertension (HTN) is a well known risk factor for atherosclerosis and peripheral arterial disease (PAD). PAD affects more than 250 million people globally and is associated with worse clinical outcomes. Although multiple studies have been performed to evaluate treatment of HTN in patients with PAD, blood pressure management in this high-risk cohort remains poor. RECENT FINDINGS: There has been conflicting evidence regarding blood pressure goals in PAD with some recent studies showing adverse outcomes with low blood pressure in this patient population. Current guidelines, however, continue to recommend treatment goals in PAD patients similar to patients without PAD. To date, no single antihypertensive drug class has shown a clear benefit in PAD population over other antihypertensive drug classes. SUMMARY: Prospective randomized trials enrolling PAD patients are required that can shed light on optimum blood pressure target and also distinguish between different antihypertensive drugs in terms of reducing adverse outcomes.
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Gupta et al. (2022) conducted a review in Peripheral arterial disease and hypertension. Blood pressure management was evaluated. Blood pressure management in patients with peripheral arterial disease lacks clear evidence for optimal targets or specific antihypertensive drug classes, highlighting the need for randomized trials.
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