Background
Polypharmacy is common among patients with peripheral arterial disease (PAD) with
a combination of medications used for risk-factor modification and medical management
of the disease itself. Interaction between commonly prescribed medications and nutritional
status has not previously been well described. This review aims to critically appraise
evidence exploring associations between medications commonly prescribed to patients
with PAD and nutritional status and provide recommendations for practice.
Methods
A comprehensive literature search was conducted to locate studies relating to nutrient
interactions among lipid-lowering, antihypertensive, antiplatelet, and oral hypoglycemic
drug classes. Quality of the evidence was rated on the basis of recommendations by
the National Health and Medical Research Council.
Results
A total of 25 articles were identified as suitable and included in the review. No
studies were specific to patients with PAD, and hence findings highlighting risk of
ubiquinone (coenzyme Q10 [CoQ10]) depletion with lipid-lowering medications, zinc
depletion with antihypertensive medications, and vitamin B12 depletion with oral hypoglycemic medications are extrapolated from heterogeneous
groups of patients and healthy adults. The body of evidence ranged in quality from
satisfactory to poor.
Conclusions
High-quality research is required to confirm the interactions suggested by the included
studies in patients with PAD specifically. It is, however, recommended that patients
with PAD that are long-term consumers of the selected medications are monitored for
CoQ10, zinc, and vitamin B12 to facilitate early identification of deficiencies and initiation of treatment. Treatment
may involve dietary intervention and/or supplementation.
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Article info
Publication history
Published online: January 21, 2016
Accepted:
October 15,
2015
Received:
July 21,
2015
Footnotes
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
