What are the ESC/ESVS guidelines for medical therapy for peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

In August 2017, the European Society for Cardiology (ESC), in collaboration with the European Society for Vascular Surgery (ESVS), issued updated guidelines on the diagnosis and treatment of PAD [16] ; these guidelines were also endorsed by the European Stroke Organisation (ESO).

Recommendations regarding best medical therapy for PAD include the following:

  • Smoking cessation is recommended in all patients with PAD (class I recommendation; evidence level B)
  • Healthy diet and physical activity are recommended for all patients with PAD (class I recommendation; evidence level C)
  • Statins are recommended in all patients with PAD (class I recommendation; evidence level A)
  • In patients with PAD, it is recommended to reduce LDL-C to < 1.8 mmol/L (70 mg/dL) or decrease it by ≥50% if baseline values are 1.8–3.5 mmol/L (70–135 mg/dL) (class I recommendation; evidence level C)
  • In diabetic patients with PAD, strict glycemic control is recommended (class I recommendation; evidence level C)
  • Antiplatelet therapy is recommended in patients with symptomatic PAD (class I recommendation; evidence level C)
  • In patients with PAD and hypertension, it is recommended to control blood pressure at < 140/90 mm Hg (class I recommendation; evidence level A)
  • Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) should be considered as first-line therapy in patients with PAD and hypertension (class I recommendation; evidence level B)

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