What are some of the main medical treatments for peripheral arterial disease?

    Last Updated: October 25, 2023

    Treatment of peripheral arterial disease focuses on the “modifiable” risk factors: smoking, physical inactivity, high blood glucose, high blood lipids, and high blood pressure.[1][2][3]

    • Stopping smoking reduces the risk of amputation and heart attack, and prolongs survival.[4]
    • Regular exercise relieves intermittent claudication (calf pain during walking) and improves exercise capacity and quality of life.[5][6]
    • Lipid-lowering drugs lessen the risk of coronary events.[7][8] If the patient has diabetes or hypertension, glucose-lowering and blood pressure-lowering therapies are also recommended.[1][9]

    Other drugs are also used to lessen symptoms of intermittent claudication and improve walking distance (e.g., cilostazol[10]) and to help prevent major cardiovascular events (e.g., clopidogrel[11][12]).

    References

    1. ^Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, Fleisher LA, Fowkes FG, Hamburg NM, Kinlay S, Lookstein R, Misra S, Mureebe L, Olin JW, Patel RA, Regensteiner JG, Schanzer A, Shishehbor MH, Stewart KJ, Treat-Jacobson D, Walsh ME2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation.(2017-Mar-21)
    2. ^Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SSHeart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association.Circulation.(2022-Feb-22)
    3. ^Golledge JUpdate on the pathophysiology and medical treatment of peripheral artery disease.Nat Rev Cardiol.(2022-Jul)
    4. ^Armstrong EJ, Wu J, Singh GD, Dawson DL, Pevec WC, Amsterdam EA, Laird JRSmoking cessation is associated with decreased mortality and improved amputation-free survival among patients with symptomatic peripheral artery disease.J Vasc Surg.(2014-Dec)
    5. ^Lane R, Harwood A, Watson L, Leng GCExercise for intermittent claudication.Cochrane Database Syst Rev.(2017-Dec-26)
    6. ^Treat-Jacobson D, McDermott MM, Bronas UG, Campia U, Collins TC, Criqui MH, Gardner AW, Hiatt WR, Regensteiner JG, Rich K,Optimal Exercise Programs for Patients With Peripheral Artery Disease: A Scientific Statement From the American Heart Association.Circulation.(2019-Jan-22)
    7. ^Aung PP, Maxwell HG, Jepson RG, Price JF, Leng GCLipid-lowering for peripheral arterial disease of the lower limb.Cochrane Database Syst Rev.(2007-Oct-17)
    8. ^Sofat S, Chen X, Chowdhury MM, Coughlin PAEffects of Statin Therapy and Dose on Cardiovascular and Limb Outcomes in Peripheral Arterial Disease: A Systematic Review and Meta-analysis.Eur J Vasc Endovasc Surg.(2021-Sep)
    9. ^Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesHypertension.(2018 Jun)
    10. ^Brown T, Forster RB, Cleanthis M, Mikhailidis DP, Stansby G, Stewart MCilostazol for intermittent claudication.Cochrane Database Syst Rev.(2021-Jun-30)
    11. ^Squizzato A, Bellesini M, Takeda A, Middeldorp S, Donadini MPClopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.Cochrane Database Syst Rev.(2017-Dec-14)
    12. ^Willems LH, Maas DPMSM, Kramers K, Reijnen MMPJ, Riksen NP, Ten Cate H, van der Vijver-Coppen RJ, de Borst GJ, Mees BME, Zeebregts CJ, Hannink G, Warlé MCAntithrombotic Therapy for Symptomatic Peripheral Arterial Disease: A Systematic Review and Network Meta-Analysis.Drugs.(2022-Aug)