Peripheral arterial disease: A systemic disease extending beyond the affected extremity

Peripheral arterial disease (PAD) is a manifestation of the atherosclerotic process and is associated with an increased risk of cerebrovascular disease, cardiovascular disease, and death. Clinicians should consider screening, both asymptomatic and symptomatic patients with the ankle-brachial index, a test with a high sensitivity and specificity. For those patients with PAD, atherosclerotic risk factors (such as smoking, dyslipidemia, hypertension, and diabetes mellitus) should be aggressively treated. In addition to exercise therapy, there is evidence available to support the use of aspirin, clopidogrel, lipid-lowering agents, pentoxifylline, and cilostazol.