Peripheral Artery Disease (PAD) has many risk factors, but some of them are more prominent than others, such as smoking, which is the single greatest modifiable risk factor for PAD and many other Cardio-vascular Diseases (CVDs). Another risk factor, which is frequently mentioned in the same breath as smoking, for PAD and CVDs in general, is hypertension.
in 2010 about 1.39 billion individuals had elevated blood pressure.
Hypertension is a very common medical condition and it was estimated that in 2010 about 1.39 billion individuals had elevated blood pressure (defined as average systolic blood pressure above 140 mm Hg and average diastolic blood pressure above 90 mm Hg). At the same time it is also the leading risk factor for morbidity and mortality (not a cause by itself) accounting for 9.4 million deaths in 2010 alone due to its association with virtually all CVDs which are the leading cause of mortality worldwide [2, 3]. More specifically Coronary Artery Disease (CAD) – is culpable for 8.92 million deaths in 2015.
Importance of PAD Measurement in Hypertensive Individuals
Screening for PAD in hypertensive patients is not only paramount from the perspective of PAD itself, but also from that of overall cardiovascular health, since those with both diseases suffer worse outcomes than those with only one. Patients with hypertension and PAD are at a greatly increased risk of myocardial infarction and stroke . The comorbidity of hypertension and PAD with other medical conditions also has detrimental effects beyond those directly connected with cardiovascular health.
Studies have shown an association between hypertension and a low ABI score (diagnosis of PAD), with a decline in cognitive functions in overweigh and obese individuals with type 2 diabetes . The effect on overall mortality is also distinctly negative. The cumulative death ratio (over a 5-year period) for hypertensive patients with PAD was twice as high (regardless of gender) in comparison with those without PAD . Additionally, while hypertension can be managed with antihypertensive drugs (in addition to other treatments such as lifestyle modification) there is no concrete evidence that antihypertensive therapy leads to a reduction of PAD incidence .
Healthcare professionals are recommended to screen hypertensive patients for PAD on the basis of ABI measurement as the health and mortality outcomes are worse for those with both diseases than for those with either.