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Cardiac Medications
Prolong Survival in Peripheral Artery Disease
posted 04/21/2006
Statins, beta blockers, aspirin and
angiotensin-cardioverting enzyme (ACE) inhibitors all decrease mortality in
patients with peripheral artery disease (PAD), investigators report.
Despite treatment guidelines that call for aggressive management of risk factors
and lifestyle to slow the progression of PAD, the effects of medications on
reducing mortality have not been well-studied, note Dr. Harm H. H. Feringa of
Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues.
The team enrolled 2,420 patients with PAD (mean age 64 years, 72% men, ankle-brachial index of 0.90 or less) in an observational study of the effects of cardiac medications and a high-risk lifestyle on longevity.
Of the total, 436 (18%) were diabetics, 581 (24%) had hypercholesterolemia, 837 (35%) were smokers, 1,162 (48%) were hypertensive, 1,056 (44%) had coronary artery disease and 214 (9%) had heart failure.
During a follow-up period of around 8 years, 44% patients died. After adjusting for risk factors, the researchers found that statin therapy had a hazard ratio of 0.46, beta blockers had a hazard ratio of 0.68, aspirin had a hazard ratio of 0.72 and ACE inhibitors carried a hazard ratio of 0.80. All were significantly associated with higher survival.
Dr. Feringa's team points out that the findings conflict with other studies
showing that beta blockers can increase mortality in PAD. They note that adding
walking or other exercise and risk factor modification, plus multi-drug therapy,
could further decrease mortality in patients with PAD.