{"id":9502,"date":"2026-01-12T17:31:46","date_gmt":"2026-01-12T14:31:46","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9502"},"modified":"2026-01-12T17:31:46","modified_gmt":"2026-01-12T14:31:46","slug":"2026-acc-aha-multisociety-pad-guidelines-pharmacologic-therapy","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/2026-acc-aha-multisociety-pad-guidelines-pharmacologic-therapy\/","title":{"rendered":"2026 ACC\/AHA Multisociety PAD Guidelines \u2013 Pharmacologic Therapy"},"content":{"rendered":"

2026 ACC\/AHA Multisociety PAD Guidelines \u2013 Pharmacologic Therapy<\/span><\/p>\n

JACC | Just Accepted \u2013 January 8, 2026<\/span><\/p>\n

Key Take-Home Messages<\/span>
\n\u2022 PAD is a high-risk systemic atherosclerotic disease \u2192 requires comprehensive medical therapy, not limb-focused treatment alone.<\/span>
\n\u2022 ACE inhibitors (or ARBs)<\/span>
\n\u2022 Class I indication \u2013 strong recommendation (should be used) in eligible PAD patients, unless contraindicated.<\/span>
\n\u2022 Considered first-line, evidence-based therapy, not optional.<\/span>
\n\u2022 Highlighted separately in PAD due to benefits beyond blood pressure control, including:<\/span>
\n\u2022 Anti-inflammatory effects<\/span>
\n\u2022 Prevention of adverse vascular remodeling<\/span>
\n\u2022 Improved endothelial function<\/span>
\n\u2022 Antiplatelet therapy<\/span>
\n\u2022 Aspirin or clopidogrel recommended for all PAD patients to reduce MI, stroke, and vascular death.<\/span>
\n\u2022 In selected high-risk patients, dual pathway inhibition (low-dose rivaroxaban + aspirin) may reduce major adverse cardiovascular and limb events.<\/span>
\n\u2022 Lipid-lowering therapy<\/span>
\n\u2022 High-intensity statins for all PAD patients, regardless of baseline LDL.<\/span>
\n\u2022 Add ezetimibe or PCSK9 inhibitors if LDL targets are not achieved.<\/span>
\n\u2022 Blood pressure management<\/span>
\n\u2022 BP control is essential.<\/span>
\n\u2022 In addition to ACEi\/ARBs, other agents (e.g., calcium channel blockers, thiazide diuretics) may be used as needed.<\/span>
\n\u2022 Diabetes management<\/span>
\n\u2022 In PAD patients with diabetes, prefer agents with proven CV benefit:<\/span>
\n\u2022 SGLT2 inhibitors<\/span>
\n\u2022 GLP-1 receptor agonists<\/span>
\n\u2022 Symptom-directed therapy<\/span>
\n\u2022 Cilostazol may improve claudication and walking distance in patients without heart failure.<\/span>
\n\u2022 Improves function and quality of life but does not reduce CV events.<\/span><\/p>\n

Core Principle<\/span><\/p>\n

Pharmacologic therapy in PAD must be systematic, guideline-directed, and comprehensive, targeting both systemic cardiovascular risk and limb outcomes, and integrated with lifestyle modification and structured exercise therapy.<\/span>
\nGuidelines include saphenous vein assessment before revascularization.<\/span><\/p>\n

https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2025.09.003<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

2026 ACC\/AHA Multisociety PAD Guidelines \u2013 Pharmacologic Therapy JACC | Just Accepted \u2013 January 8, 2026 Key Take-Home Messages \u2022 PAD is a high-risk systemic atherosclerotic disease \u2192 requires comprehensive medical therapy, not limb-focused treatment alone. \u2022 ACE inhibitors (or ARBs) \u2022 Class I indication \u2013 strong recommendation (should be used) in eligible PAD patients, […]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9502","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9502","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9502"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9502\/revisions"}],"predecessor-version":[{"id":9503,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9502\/revisions\/9503"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9502"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9502"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}