What is the role of statins in peripheral arterial disease (PAD)?

• A. Indicated in all patients with PAD regardless of LDL cholesterol; may improve leg symptoms independent of lipid-lowering effects.
• B. Only used if LDL cholesterol is elevated.
• C. They are contraindicated in PAD.
• D. They are used solely to reduce blood pressure in PAD.

Answer: (D)

In PAD, the main purpose of statins is to lower LDL cholesterol and reduce overall cardiovascular risk. PAD reflects widespread atherosclerosis, so using statins helps protect the heart and brain from future heart attacks and strokes, which PAD patients are particularly prone to. This benefit is recommended for all individuals with PAD, regardless of their starting LDL level, because the risk reduction applies even when LDL appears normal.

Statins are not a tool for lowering blood pressure, and they don’t primarily aim to ease leg pain from claudication. They may indirectly influence the disease course by stabilizing plaques and reducing inflammation, but their core value in PAD is cardiovascular risk reduction and lipid management, not blood pressure control. They are appropriate in PAD unless there is a specific contraindication, and they should be part of a broader strategy including antiplatelet therapy, exercise, and risk-factor modification.