LDL lowering in peripheral arterial disease: are there benefits beyond reducing cardiovascular morbidity and mortality?

Peripheral arterial disease affecting the lower extremities is associated with increased mortality due to cardiovascular events and reduced functional capacity due to claudication. There is abundant evidence to support the role of lipid lowering with statins in preventing cardiovascular events in patients with peripheral arterial disease. Over the last 10 years, multiple studies have been designed to test the theory that LDL C lowering with statins could result in improved exercise performance in patients with peripheral arterial disease. However, this remains an active area of investigation to better understand how the pleiotropic effects of statins could lead to enhanced functional capacity for patients with claudication. Furthermore, new insights into the complex pathophysiology of claudication may help us to understand the potential role of lipid lowering therapy in alleviating exercise induced symptoms.