- by Dr SUNIL DWIVEDI
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- Aug 24 2017
MEDICATION FOR PERIPHERAL ARTERY DISEASE
- Cholesterol-lowering medications. The doctor may prescribe you a cholesterol-lowering drug called a statin to reduce your risk factor of heart attack and stroke. The goal for people who have peripheral artery disease is to reduce low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, to less than 100 milligrams per deciliter (mg/dL), or 2.6 millimoles per liter (mmol/L). This goal is reduced further if you have additional major risk factors for heart attack and stroke, especially diabetes or continued smoking.
- High blood pressure medications. If your blood pressure is high, your doctor may prescribe medications to lower it. This therapy aims to reduce your systolic blood pressure (the top number of the two numbers) to 140 millimeters of mercury (mm Hg) or lower and your diastolic blood pressure (the bottom number) to 90 mm Hg or lower. Your blood pressure target is under 130/80 mm Hg if you have diabetes.
- Medication to control blood sugar. It becomes even more important to control your blood sugar (glucose) levels if you also have diabetes. Discuss what your blood sugar goals are with your doctor and find out what steps you need to take to achieve these goals.
- Medications to prevent blood clots. It's important to reduce your risk of blood clots as peripheral artery disease is related to reduced blood flow to your limbs. Complete blockage can occur due to a blood clot in an already narrowed blood vessel and cause tissue death. Daily aspirin may be prescribed by your doctor to help prevent blood clots.
- Symptom-relief medications. Many medications like cilostazol are available these days that increase blood flow to the limbs, both by preventing blood clots and by widening the blood vessels. This drug is indicated to treat symptoms of claudication, such as leg pain, for people who have peripheral artery disease.
Angioplasty and surgery
In extreme cases, angioplasty or surgery may be necessary to treat peripheral artery disease that's causing intermittent claudication:
- Angioplasty. A small hollow tube (catheter) is threaded through a blood vessel to the affected artery in this procedure. A small balloon on the tip of the catheter is inflated at that point to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow. It may be required to insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.
- Bypass surgery. In this procedure your doctor may create a graft bypass using a vessel from another part of your body or a blood vessel made of synthetic fabric. This technique allows blood to flow around — or bypass — the blocked or narrowed artery.
- Thrombolytic therapy. Your doctor may inject a clot-dissolving drug into your artery, if you have a blood clot blocking an artery, at the point of the clot to break it up.
Supervised exercise program
Your doctor may prescribe a supervised exercise training program, in addition to medications or surgery, to increase the distance you can walk pain-free. Regular exercise improves symptoms of PAD by a number of methods, including helping your body use oxygen more efficiently.
The symptoms of peripheral artery disease can be managed effectively with lifestyle measures and the progression of the disease can be slowed, especially by quitting smoking. To stabilize or improve PAD:
- Stop smoking. Constriction and damage of your arteries is contributed by smoking and is a significant risk factor for the development and worsening of PAD. Quitting is the most important thing you can do to reduce your risk of complications. Ask your doctor about smoking cessation options if you're having trouble quitting on your own. There are medications available to help you quit.
- Exercise. It is important to exercise regularly to ensure success in treatment of PAD. Success is often measured by how far you can walk without pain. Proper exercise helps condition your muscles to use oxygen more efficiently. With the help of your doctor, you can develop an appropriate exercise plan. He or she may refer you to a claudication exercise rehabilitation program.
- Eat a healthy diet. A diet low in saturated fat can help control your blood pressure and cholesterol levels, which contribute to atherosclerosis.
- Avoid certain cold medications. Remedies for cough and cold that are available over-the-counter contain pseudoephedrine that can constrict your blood vessels and may increase your PAD symptoms.
Careful foot care
Care of the feet is very important in addition to the above suggestions. Follow this advice to care for your feet:
- Daily washing of feet is important. After washing dry them thoroughly and moisturize often to prevent cracks that can lead to infection. Don't moisturize between the toes, however, as this can encourage fungal growth.
- Your shoes should be well-fitting.
- Treat aggressively any fungal infections of the feet, such as athlete's foot.
- Take care when trimming your nails.
- Don't walk barefoot.
- Treat bunions, corns or calluses.
- Consult a doctor at the first sign of a sore or injury to your skin.
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