Management of High Blood Pressure in Peripheral Arterial Disease

Arterial hypertension (HTA) is a promoter of peripheral arterial disease (PAD) in association with other atherosclerotic risk factors. Systolic HTA is the most frequently noted form in such disease, secondary to marked increase in large artery stiffness. The existence of PAD confers on the hypertensive patient a very high cardiovascular (CV) risk, requiring an intensive global therapeutical approach. Treating HTA is one of such beneficial actions. The optimal blood pressure (BP) to be reached is at least < 140/90 mmHg but lower BP should be targeted if possible (< or = 130/80 mmHg). First of all, a modification of the lifestyle and diet should be proposed. But to reach such a low target, different antihypertensive agents must be very often used in association. The inhibitors of the renin-angiotensin system constitute one of the main axis of such drug treatment, after having avoided the pitfall of renal artery stenosis.