Which medication is typically recommended for initial therapy to prevent cardiovascular disease in patients with symptomatic PAD?

Aspirin 81 mg daily is generally recommended as the initial therapy for patients with symptomatic peripheral artery disease (PAD) to prevent cardiovascular disease. This recommendation is rooted in the anti-platelet properties of aspirin, which help reduce the risk of thromboembolic events such as heart attacks and strokes in at-risk populations. The anti-inflammatory effects of aspirin also play a role in its efficacy for patients who present with PAD due to underlying atherosclerotic disease.

The use of aspirin in symptomatic PAD patients has been supported by clinical trials demonstrating a reduction in major cardiovascular events when aspirin is used as part of a treatment regimen. The recommended low dose (81 mg) minimizes the risk of gastrointestinal side effects while still providing an adequate antiplatelet effect.

Other medications may also play a role in managing cardiovascular risk in patients with PAD, but aspirin is the most established choice for initial therapy. Clopidogrel is considered when patients are intolerant to aspirin or when dual antiplatelet therapy is needed in certain situations, although it is not typically the first-line agent. Dipyridamole and warfarin are used in specific contexts but are not standard first-line options for the prevention of cardiovascular events in PAD.