Recommendation-Specific Supportive Text
There is no major difference in the relative risk reduction in CVD from BP-lowering therapy between patients with hypertension and PAD and patients without PAD. There is also no evidence that any one class of antihypertensive medication or strategy is superior.
In the INVEST (International Verapamil-Trandolapril) study, the beta blocker atenolol (with or without hydrochlorothiazide) was compared with the CCB verapamil (with or without perindopril). The study showed no significant difference in CVD outcomes between the 2 drug regimens in patients with and without PAD. No trials have reported the effects of a higher versus a lower BP goal in patients with PAD. In the 1 trial (ALLHAT) that reported the effects of different classes of BP medications on PAD as an outcome, there was no significant difference by medication class.
REF. 2017 High Blood Pressure Clinical Practice Guideline
