Many PAD Patients Are Skipping Preventive Drugs

June 20, 2011 -- Millions of people with peripheral artery disease (PAD) aren't taking preventive medication to reduce heart disease risk.

A new study shows that many people with PAD may benefit from taking medications to optimize their blood pressure and cholesterol levels. Use of these and other preventive medications may reduce the risk of heart attack, stroke, and death in people with peripheral artery disease. But only about a third of people with PAD are taking them.

"We found that taking two or more of these medications was associated with a 65 percent lower rate of death from all causes," says researcher Reena L. Pande, MD, an instructor at the Harvard Medical School in Boston, in a news release. "The study tells us that millions of individuals identified with PAD by a simple non-invasive screening test are not receiving medications that may reduce their risk of death." 

Peripheral artery disease is the result of atherosclerosis or plaque in the arteries that supply blood to the legs, arms, head, and organs. People with the disease are at much higher risk of having a heart attack or stroke due to "blockages" in the arteries supplying the heart or brain.

The use of blood pressure and cholesterol-lowering drugs, such as ACE inhibitors, angiotensin receptor blockers, statins, and aspirin are recommended in people with PAD to reduce this risk.

PAD Drugs Underused

In the study, researchers analyzed medication use in a group of 7,458 adults with peripheral artery disease. The participants were enrolled in a nationwide survey from 1999 to 2006.

Researchers used a screening test called the ankle brachial index to identify people with peripheral artery disease without any signs of heart disease. This test compares the blood pressure in a person's arm to the blood pressure at the ankle.

A low index indicates a narrowing or blockage in the arteries supplying blood to the legs and is a sign of PAD.

The results, published in Circulation: Journal of the American Heart Association, showed:

• Two out of three (about 5 million adults) in the U.S with PAD are not taking cholesterol-lowering statin medications.
• Three out of four or about 5.4 million with PAD are not taking ACE inhibitors or angiotensin receptor blockers to lower blood pressure.
•  Two out of three adults with PAD are not taking aspirin.

After adjusting for other risk factors, researchers found people with PAD who were taking two or more of the recommended medications had a 65% lower risk of death from any cause during the study period than those who didn't take the medications.

Researchers say the results suggest that peripheral artery disease merits more aggressive treatment and that use of blood pressure and cholesterol-lowering medications can significantly reduce the risks associated with the disease.