The fact that the medicines had such a strong effect may not be surprising, Henke says, when you consider that they've been shown to do the same for patients with clogged heart arteries who have heart bypass surgery or angioplasty.

So, Henke and his colleagues suggest that millions more people whose legs hurt because of early-stage PAD should get a full cardiovascular checkup to look at their overall blood vessel health and determine if they could be helped by medication, or by changes in diet, exercise habits and tobacco use.

After all, he notes, the same factors that cause arteries in the heart to narrow or become blocked -- including high cholesterol, high blood pressure, tobacco use, diabetes and lack of exercise -- affect arteries in the legs and arms too.

"Many of the same strategies that help heart patients do better have also been shown to help PAD patients reduce their pain and increase their walking distance, including exercise, quitting smoking and lowering cholesterol and blood pressure," says Henke. "It stands to reason that the same medications could help, too -- this is a systemic, whole-body disease."

Henke and his colleagues were dismayed to find that even though scientific evidence shows statins and ACE inhibitors can help overall cardiovascular health, about half of the PAD patients studied had gotten all the way to surgery without taking them.

"These were all patients who were having infrainguinal bypass surgery to address severe pain and non-healing wounds, or to save their legs from amputation, but many of them apparently had gone without the kind of whole-body cardiovascular care that might have led to the use of one or more of these drugs," says Henke.

However, the vast majority (93 percent) were taking one or more blood-thinning drugs to reduce pain and prevent blood clots, mostly aspirin but also prescription drugs clopidogrel and warfarin.

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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
27-Jan-2004