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Antihypertensive treatment in critical limb ischaemia
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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.
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 disease, critical limb ischaemia, blood pressure
About this articleTitle
Antihypertensive treatment in critical limb ischaemia
Journal
Issue
Article type
Review paper
Pages
195-197
Published online
2016-12-29
Page views
852
Article views/downloads
2347
DOI
Bibliographic record
Arterial Hypertension 2016;20(4):195-197.
Keywords
peripheral artery disease
critical limb ischaemia
blood pressure
Authors
Anders Gottsäter
Peter M. Nilsson
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