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Review
. 2022 Oct 28;1(6):100513.
doi: 10.1016/j.jscai.2022.100513. eCollection 2022 Nov-Dec.

Management of Peripheral Arterial Disease: Lifestyle Modifications and Medical Therapies

R Wilson King  1   2 , Mario Enrico Canonico  2   3 , Marc P Bonaca  2   4 , Connie N Hess  2   4
Affiliations
Review

Management of Peripheral Arterial Disease: Lifestyle Modifications and Medical Therapies

R Wilson King et al. J Soc Cardiovasc Angiogr Interv. .

Abstract

Peripheral artery disease (PAD) commonly refers to atherosclerotic narrowing of noncoronary arteries, primarily those supplying the lower extremities. The risk factors for PAD include smoking, hyperlipidemia, hypertension, and diabetes mellitus. Patients with PAD are at a heightened risk of major adverse cardiovascular events (including myocardial infarction, stroke, and cardiovascular death) and major adverse limb events (including progressive symptoms or limb ischemia requiring peripheral revascularization, amputation, and acute limb ischemia), highlighting the need for guideline-directed therapies. Lifestyle modifications and medical therapies are utilized to improve function and outcomes in this patient population. Adherence to a healthy diet and smoking cessation are both associated with better outcomes in patients with PAD. Medical therapies targeting axes of risk, including lipid-modifying therapies, antithrombotic therapies, and targeted diabetes therapies, are available to reduce this risk in patients with PAD; however, significant residual risk remains. Unfortunately, despite guideline recommendations and efforts at education, even available medical therapies remain underutilized in patients with PAD. Continued development of novel therapies and efforts to improve the provision of care in patients with PAD are needed.

Keywords: lifestyle modification; medical therapy; peripheral arterial disease; pharmacotherapy.

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Figures

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Graphical abstract
Central Illustration
Central Illustration
Medical therapy for peripheral artery disease. ACEi/ARB, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; ASA, acetylsalicylic acid; DAPT, dual-antiplatelet therapy; GLP-1 RA, glucagon-like peptide-1 receptor agonist; LDL-C, low-density lipoprotein-cholesterol; LER, lower-extremity revascularization; MALE, major adverse limb events; MI, myocardial infarction; PAD, peripheral artery disease; PCSK9i, proprotein convertase subtilisin/kexin type 9 inhibitor; SGLT2i, sodium-glucose cotransporter 2 inhibitor.
See this image and copyright information in PMC

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