LDL Lowering in Peripheral Arterial Disease

Are There Benefits Beyond Reducing Cardiovascular Morbidity and Mortality?

Amy W Pollak; Christopher M Kramer


Clin Lipidology. 2012;7(2):141-149. 

In This Article


There is a clear reduction in cardiovascular events with statin therapy and LDL lowering in patients with PAD. Given the symptoms of leg discomfort and reduction in exercise capacity in patients with PAD, there remains strong interest in medical therapy aimed at improving these symptoms. Although no individual trial has shown an increase in peak treadmill-walking time with statin therapy, several trials demonstrate a reduction in claudication symptoms. The Cochrane meta-analysis found an improvement in 6-min walk distance with statins, which may be more reflective of activities of daily living than an exercise treadmill test.[11] Clinical trials of statin therapy and exercise performance are influenced by the baseline LDL level, pre-existing treatment with statin drugs and study duration. Insight into the pleiotropic effects of statins and the complex pathophysiology of claudication has provided new avenues to understand how exercise capacity can be improved in PAD.


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