Cholesterol in peripheral vascular disease - a suitable case for treatment?

We assessed the prevalence of conventional risk factors for ischaemic heart disease in patients with peripheral vascular disease, and the scope for pr eventative treatment with lipid-lowering therapy in this group, by retrospe ctively reviewing 299 patients who had undergone peripheral angiography in 1996. A total of 278 patients had severe peripheral vascular disease; 44% w ere current smokers at the time of their angiogram, and 36% had a history o f coronary artery disease (either myocardial infarction, coronary artery by pass surgery, coronary angioplasty or angina). Cholesterol had been measure d in 80 (27%) patients, of whom 26 (9%) were receiving treatment for hyperc holesterolaemia. Patients with a history of ischaemic heart disease were mo re likely to have had their chotesterol measured (50% vs. 15%; p<0.001). Hy pertension (defined as systolic > 160 mmHg or diastolic > 90 mmHg) was pres ent in 44%. There was no difference in the distribution of risk factors bet ween those with and those without known ischaemic heart disease. There is a high prevalence of modifiable risk factors for coronary disease in patient s with severe peripheral vascular disease. Effective prevention is availabl e for coronary artery disease, but we found low levels of treatment. There is considerable scope for intervention to reduce the risk of coronary disea se in such patients.