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This guide can help you talk with your doctor or nurse about treatments for renal artery stenosis (pronounced “steh-NO-sis”). The information in this guide comes from a government-funded review of research about the treatment of RAS. It talks about: Health problems caused by RAS, like high blood pressure and kidney damage. Two kinds of treatment for RAS.

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: June 26, 2007

Coronary artery disease (CAD) is caused by the narrowing of the large blood vessels that supply the heart with oxygen. These vessels are called coronary arteries. The symptoms of CAD can vary greatly, depending on how long the arteries have been narrowed and how constricted they are.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 27, 2017

Atherosclerosis, or hardening of the arteries, results in narrowing and blockage of the arteries and can reduce the blood supply to the legs, causing peripheral arterial disease. Intermittent claudication (IC) is a cramp‐like pain felt in the leg muscles that is brought on by walking and is relieved by standing still or resting. Pentoxifylline is a drug that is used to relieve IC while improving people's walking capacity. It decreases blood viscosity and improves red blood cell flexibility, promoting microcirculatory blood flow and increasing oxygen in the tissues. This review looked at all available evidence from randomised controlled trials on the efficiency of pentoxifylline for treatment of IC.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: September 29, 2015

The human body needs cholesterol to work properly. For example, cholesterol is needed to make certain hormones and it is an important building block for cell walls.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 7, 2017

Abnormal calcium and phosphorous levels in the blood and tissues occur in chronic kidney disease. These changes are linked to shorter survival and hardening of the arteries leading to heart disease. Standard therapy for abnormal calcium and other mineral levels includes dietary restrictions, phosphorous binders and vitamin D compounds. A newer treatment called cinacalcet showed promise for improving abnormal mineral levels but the effects of this drug on patient outcomes (the way patients feel function and survive) were unclear from early studies. We have updated an earlier review dated 2006 to include studies that assessed the effects of cinacalcet in about 7500 people with chronic kidney disease. While cinacalcet improves some blood abnormalities, it does not improve risk of death or heart disease in people treated with dialysis. In addition, people who take cinacalcet may experience increased nausea, vomiting and the need for blood tests to check blood calcium levels. The current research is high‐quality and means that additional new studies are unlikely to change our confidence in these results. Information for the use of cinacalcet in people with milder forms of kidney disease and those with a kidney transplant is insufficient to guide decision making.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 9, 2014

Intermittent claudication is a cramping leg pain that develops during exercise and is relieved by a short period of rest. It is caused by inadequate blood flow to the muscles of the leg because of atherosclerosis (hardening and narrowing of the arteries). Intermittent claudication is closely associated with other vascular diseases, such as a heart attack or stroke. Therefore, all patients with intermittent claudication should receive cardiovascular risk management and lifestyle coaching to reduce cardiovascular risk factors.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 4, 2014

When blood pressure is consistently high it can lead to complications such as a heart attack (myocardial infarction) or stroke. Both peripheral arterial disease (PAD), a condition that affects the blood vessels (arteries) carrying the blood to the legs, arms, and stomach area, and high blood pressure (hypertension) are associated with atherosclerosis. This is hardening of the arteries which is caused by deposits of fat, cholesterol and other substances inside the blood vessels. PAD is diagnosed when the blood supply to the legs is restricted causing pain and cramping that limits walking (intermittent claudication). It is measured by the walking distance (on a treadmill) before onset of pain (claudication distance) or ankle brachial index (ABI), the ratio of the blood pressure in the arms to the blood pressure in the legs. If the blood pressure is lower in the legs compared to the arms (ABI of less than 1.0) this indicates blocked arteries in the legs (or PAD). PAD can progress to pain at rest and critical limb ischaemia (sudden lack of blood flow to a limb caused by a blood clot or fatty deposit blockage) that requires revascularisation (restoring the blood flow by opening up the blocked blood vessel) or amputation. Treatment of hypertension to reduce cardiovascular events (heart attack or stroke) and death needs careful consideration in people with PAD. Anti‐hypertensive medications may worsen the PAD symptoms by further reducing blood flow and supply of oxygen to the limbs, and may have long‐term effects on disease progression. The evidence from randomised controlled trials (RCTs) examining the risks and benefits of various anti‐hypertensive drugs on measures of PAD is lacking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: December 4, 2013

Intermittent claudication, affecting approximately 4.5% of the general population aged 40 years and older, is a common symptomatic form of peripheral arterial disease and is characterised by pain in the calf or buttock in the legs that starts with walking and eases with rest. This leg pain is caused by reduced blood flow to leg muscles due to a blockage in the leg arteries as a consequence of atherosclerosis (hardening and plaque buildup in the arteries). People with intermittent claudication experience severely limited walking distances, resulting in a sedentary lifestyle and decreased quality of life.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2018

People with prolonged or recurrent chest pain may have a condition called unstable angina (UA) or suffer a certain type of heart attack called non‐ST elevation myocardial infarction (NSTEMI). People with either of these two conditions may be managed by either one of two treatment strategies: the routine invasive strategy, or the conservative or 'selective invasive strategy'. With the first approach, patients have a catheter (a long, patent tube) inserted into the arteries that bring blood to the heart muscle itself, called the coronary arteries. The main objective behind inserting this catheter (in other words, to perform a procedure called coronary angiography) is to look for thickening and hardening of the vessel. If a significant narrowing or a complicated plaque is found, then the artery may be dilated by inserting a balloon catheter that can be inflated wherever the vessel is particularly narrow, so as to open the vessel and improve blood flow. The vessel is held open by inserting a metallic stent. In some cases, the region of vessel narrowing is not amenable to this approach and surgery to bypass it is required. With the other, conservative or 'selective invasive' strategy, patients are initially treated with drugs, and only those who continue to suffer further chest pain or who demonstrate evidence of ongoing coronary artery narrowing via other non‐invasive tests, such as stress testing or imaging, undergo coronary angiography and revascularisation if indicated. In this Cochrane review, researchers examined the available evidence to determine which strategy is better.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: May 26, 2016

Intermittent claudication is a cramping leg pain that occurs during walking and is relieved by a short period of rest. It is caused by inadequate blood flow to the muscles of the leg due to atherosclerosis (hardening of the arteries). Exercise therapy provides significant symptomatic benefit for patients with intermittent claudication. Patients are recommended to walk at least three times a week by themselves. However, they can also participate in a formal supervised exercise program that involves walking on a treadmill or complete a structured home‐based exercise program with an observation component (e.g., exercise logbooks, pedometers).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2018

The treatment of cancer may cause health problems (late effects) for childhood cancer survivors months or years after successful treatment has ended. Get information about the long-term physical, psychological and social effects of treatment for childhood cancer in this expert-reviewed summary.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: November 21, 2017

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