Atherosclerotic peripheral arterial disease

I70.90-1

DESCRIPTION

History and palpation of pulses confirms diagnosis.

GENERAL MEASURES

Smoking cessation is essential and is the single most important intervention to prevent progression.
Exercise within exercise tolerance and other lifestyle modifications.
See: Ischaemic heart disease and atherosclerosis, prevention.

MEDICINE TREATMENT

Long-term prophylaxis for thrombosis:

  • Aspirin, oral, 150 mg daily.
  • HMGCoA reductase inhibitors (statins), e.g.:
    • Simvastatin, oral, 40 mg at night.

LoEI [35]

Patients on protease inhibitor:

  • Atorvastatin, oral, 10 mg at night.

LoEI [36]

Patients on amlodipine (and not on a protease inhibitor):

  • Simvastatin, oral, 10–20 mg at night.

LoEI [37]

If patient complains of muscle pain:

Reduce dose:

  • HMGCoA reductase inhibitors (statins), e.g.:
    • Simvastatin, oral, 10 mg at night.

OR

  • Consult specialist for further management.

LoEI [38]

Therapy should be initiated together with appropriate lifestyle modification. See: Ischaemic heart disease and atherosclerosis, prevention.

REFERRAL

Ongoing vascular insufficiency, which may be surgically reversible.