Role of ACE Inhibitors and Angiotensin Receptor Blockers in Peripheral Artery Disease

Peripheral artery disease (PAD) is a type of atherosclerotic vascular disease that significantly increases the risk of cardiovascular events and mortality. PAD is often underdiagnosed due to lack of awareness about symptoms like critical limb ischemia and intermittent claudication. Diagnosis commonly involves measuring the ankle-brachial index (ABI), but conditions like osteoarthritis can mimic PAD. Hypertension is a major risk factor for PAD, linked to endothelial dysfunction. ACE inhibitors and angiotensin receptor blockers (ARBs) improve endothelial function and are recommended for PAD treatment by reducing microalbuminuria and cardiovascular risks. Studies like the HOPE trial have shown ACE inhibitors reduce cardiovascular mortality in PAD patients. However, other trials like ONTARGET did not show significant benefits from combining ARBs and ACE inhibitors. More research is needed to explore the full efficacy of antihypertensive agents in managing PAD.