Medical treatment

Update on Pathophysiology and Medical Treatment of Peripheral Arterial Disease

This article was originally published here

Nat Rev Cardiol. 2022 Jan 7. doi: 10.1038/s41569-021-00663-9. Online ahead of print.

ABSTRACT

Approximately 6% of adults worldwide suffer from atherosclerosis and thrombosis of the lower extremity arteries (peripheral arterial disease (PAD)) and the prevalence is increasing. PAD causes leg pain, impaired health-related quality of life, immobility, tissue loss, and a high risk of major adverse events including myocardial infarction, stroke stroke, revascularization, amputation and death. In this review, I describe the pathophysiology, presentation, results, preclinical research, and medical management of PAD. Established treatments for PAD include antithrombotic drugs, such as aspirin and clopidogrel, and drugs to treat dyslipidemia, hypertension, and diabetes mellitus. Randomized controlled trials have shown that these treatments reduce the risk of major adverse events. The drug cilostazol, exercise therapy, and revascularization are the current treatment options for PAD limb symptoms, but each has its limitations. New therapies to promote collateral growth and new capillaries and to treat PAD-related myopathy are being investigated. Methods to improve the implementation of evidence-based medical management, novel drug therapies, and rehabilitation programs for PAD-related pain, functional impairment, and ischemic foot disease are important areas for future research.

PMID:34997200 | DOI: 10.1038/s41569-021-00663-9