Hypertension is a cardiovascular syndrome that often does not exist independently, and patients with long-term hypertension often have a combination of multiple diseases, especially atherosclerotic disease. What should be noted when hypertension is combined with peripheral vascular disease? 1. Recognizing peripheral vascular disease Peripheral vascular disease includes renal artery, carotid artery, lower extremity artery and other diseases. This section focuses on peripheral artery disease (PAD). The estimated prevalence of PAD in our population aged >60 years is more than 10%. Since PAD is a common manifestation of systemic atherosclerosis, the goal of treatment is not only to maintain the function of the affected limb, reduce or eliminate symptoms, and prevent disease progression, but more importantly, to reduce the risk of cardiovascular and cerebrovascular events. Treatment measures include conservative treatment, percutaneous intervention and surgery. For conservative treatment, every effort should be made to correct risk factors that may lead to vascular obstruction in order to slow the progression of the disease. Formal exercise training under medical supervision in patients with mild to moderate symptoms can significantly increase the distance without intermittent claudication. Percutaneous intervention and surgical revascularization are the most effective methods for immediate relief of PAD symptoms and are used in patients with severe symptoms for whom conservative treatment has failed. 2. Considerations for peripheral vascular disease combined with hypertension It is generally believed that patients with lower extremity arterial disease combined with hypertension should receive anti-hypertensive therapy, and lowering the blood pressure to meet the standard is beneficial to reduce the risk of cardiovascular and cerebrovascular events. Blood flow to the affected extremity may decrease during BP lowering, which is tolerated by most patients, but a small number of patients with severe ischemia may experience a further decrease in blood flow, leading to worsening of symptoms, so this possibility needs to be considered when lowering BP in critically ill patients, especially to avoid excessive BP lowering. In patients with symptomatic lower extremity arterial disease without hypertension, studies have shown that the use of angiotensin-converting enzyme inhibitors (prilosec) is beneficial in reducing the risk of cardiac and cerebrovascular events. Our latest guidelines recommend that blood pressure should be controlled to <140/90 mmHg in patients with lower extremity arterial disease with hypertension, and that the drugs of choice are calcium antagonists (diphenhydramine), angiotensin-converting enzyme inhibitors (priligy), or angiotensin receptor antagonists (sartans). Selective β1 receptor blockers are effective in the treatment of peripheral vascular disease combined with hypertension, generally do not increase the resistance of diseased vessels, have a preventive effect on coronary events, and are therefore not contraindicated. Diuretics are not recommended.