Vol 20, No 4 (2016)
Review paper
Published online: 2016-12-29
Antihypertensive treatment in critical limb ischaemia
DOI: 10.5603/AH.2016.0020
Arterial Hypertension 2016;20(4):195-197.
Abstract
Peripheral artery disease (PAD) is defined as atherosclerotic arterial occlusive disease of the lower extremities, manifesting as intermittent claudication (IC, pain induced by walking) or critical limb ischaemia (CLI, rest pain or ulcerations). PAD guidelines recommend strict control of cardiovascular risk factors, and European guidelines on hypertension recommend a blood pressure (BP) target < 140/90 mm Hg also in PAD patients. As the pressure in the affected extremity might be of relevance for the prognosis concerning limb salvage in CLI, the traditional approach was to avoid beta-blockers and allow a slightly higher BP in CLI. Both theoretical considerations and observational data support aggressive BP lowering also in CLI; however, in the absence of randomized studies on BP lowering in this setting it cannot be definitely established that current recommendations on BP lowering apply also in CLI.
Keywords: peripheral artery diseasecritical limb ischaemiablood pressure
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