Aggressive medical treatment in PAD

Dr Sonia Anand is a professor in the Division of Cardiology, associate chair of Equity and Diversity in the Department of Medicine, Canada Research Chair in Ethnic Diversity and Cardiovascular Disease, and director of the Population Genomics Program at McMaster University.

Should aggressive medical treatment be used in every patient with peripheral artery disease (PAD), or should it be adjusted to disease severity?

Sonia Anand, MD, PhD: We have excellent medical therapies available. In order to prevent progression of PAD, early disease would be best treated with multiple medical therapies.

As I mentioned, smoking cessation in mild disease is crucial. The use of an antithrombotic agent, like aspirin or low-dose rivaroxaban plus aspirin, is also crucial, and so is lipid lowering with a statin and making sure that the patient’s blood pressure is well controlled. These would be the 4 steps that should be initiated early on. If the patient continues to progress, we can think of more expensive and potent therapies thereafter.