Professional Practice Guide -FCSV-EN

26 Professional Practice Guide 5. Pharmacological Management CONTROLLING CARDIOVASCULAR RISK FACTORS Patients living with PAD are at very high cardiovascular risk. At five years, the risk of cardiovascular events is approximately 20%, and mortality ranges from 10% to 15%. By comparison, patients with both PAD and concomitant coronary artery disease have a risk that is twice as high as that of patients with coronary artery disease alone.¹ 5.1 HYPERTENSION According to Hypertension Canada’s Clinical Practice Guidelines,² the target systolic blood pressure < 140 mmHg for all patients with hypertension. This target is lowered to < 130 mmHg in patients with diabetes. In addition, a systolic target of < 120 mmHg may be considered in non-diabetic patients at high cardiovascular risk. This includes patients with cardiovascular disease. As demonstrated in the SPRINT study³, this approach reduces the risk of cardiovascular events and mortality. It should be noted that accurate blood pressure measurement is essential to ensure optimal management and to avoid both overtreatment and therapeutic inertia. The use of automated serial blood pressure measurements, with averaging of readings, is recommended. An angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB) is suggested as first-line therapy. ↗ N.B. The following text is intended as a general guide for the management of PAD. For more detailed information, refer to the clinical practice guidelines cited in this section. (...) patients with both PAD and concomitant coronary artery disease have a risk that is twice as high as that of patients with coronary artery disease alone.¹