Recommendations for Antiplatelet, Statin, and Antihypertensive Agents
COR	LOE	Recommendations
Antiplatelet Agents
I	A	Antiplatelet therapy with aspirin alone (range 75–325 mg per day) or clopidogrel alone (75 mg per day) is recommended to reduce MI, stroke, and vascular death in patients with symptomatic PAD.121–124
IIa	C-EO	In asymptomatic patients with PAD (ABI ≤0.90), antiplatelet therapy is reasonable to reduce the risk of MI, stroke, or vascular death.
IIb	B-R	In asymptomatic patients with borderline ABI (0.91–0.99), the usefulness of antiplatelet therapy to reduce the risk of MI, stroke, or vascular death is uncertain.67,68
IIb	B-R	The effectiveness of dual antiplatelet therapy (aspirin and clopidogrel) to reduce the risk of cardiovascular ischemic events in patients with symptomatic PAD is not well established.125,126
IIb	C-LD	Dual antiplatelet therapy (aspirin and clopidogrel) may be reasonable to reduce the risk of limb-related events in patients with symptomatic PAD after lower extremity revascularization.127–130
IIb	B-R	The overall clinical benefit of vorapaxar added to existing antiplatelet therapy in patients with symptomatic PAD is uncertain.131–134
Statin Agents
I	A	Treatment with a statin medication is indicated for all patients with PAD.88,135–139
Antihypertensive Agents
I	A	Antihypertensive therapy should be administered to patients with hypertension and PAD to reduce the risk of MI, stroke, heart failure, and cardiovascular death.140–144
IIa	A	The use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers can be effective to reduce the risk of cardiovascular ischemic events in patients with PAD.143,145,146
Oral Anticoagulation
IIb	B-R	The usefulness of anticoagulation to improve patency after lower extremity autogenous vein or prosthetic bypass is uncertain.147–149
III: Harm	A	Anticoagulation should not be used to reduce the risk of cardiovascular ischemic events in patients with PAD.148,150–152