Medical Treatment of Peripheral Arterial Disease and Claudication

doi:10.1056/NEJM200105243442108

Volume 344:1608-1621		May 24, 2001		Number 21

Medical Treatment of Peripheral Arterial Disease and Claudication

William R. Hiatt, M.D.

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Peripheral arterial disease, which is caused by atheroscleroticocclusion of the arteries to the legs, is an important manifestationof systemic atherosclerosis. The age-adjusted prevalence ofperipheral arterial disease is approximately 12 percent, andthe disorder affects men and women equally (Table 1).⁷^,⁸ Patientswith peripheral arterial disease, even in the absence of a historyof myocardial infarction or ischemic stroke, have approximatelythe same relative risk of death from cardiovascular causes asdo patients with a history of coronary or cerebrovascular disease(Table 2).¹²^,¹⁵ In patients with peripheral arterial disease,the rate of death from . . . [Full Text of this Article]

Clinical Manifestations

Modification of Risk Factors

Smoking Cessation

Treatment of Hyperlipidemia

Treatment of Diabetes Mellitus

Treatment of Hypertension

Additional Approaches to Risk Modification

Antiplatelet-Drug Therapy

Aspirin

Ticlopidine

Clopidogrel

Other Antiplatelet Drugs

Nonpharmacologic Therapy for Claudication

Goals of Therapy

Exercise Therapy

Drug Therapy for Claudication

Vasodilator Drugs

Pentoxifylline

Cilostazol

Naftidrofuryl

Levocarnitine and Propionyl Levocarnitine

Prostaglandins

Other Drugs

Conclusions

Source Information

From the Section of Vascular Medicine, Divisions of Geriatrics and Cardiology, Department of Medicine, University of Colorado School of Medicine, and the Colorado Prevention Center, Denver.

Address reprint requests to Dr. Hiatt at the Colorado Prevention Center, 789 Sherman St., Suite 200, Denver, CO 80203, or at will.hiatt@uchsc.edu.

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