Analysis Shows Growing Global PAD Prevalence

The number of people with peripheral artery disease (PAD) worldwide increased 23.5 percent, from about 164 million in 2000 to 202 million in 2010, highlighting a growing global health problem, according to an analysis published July 31 The Lancet.

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The analysis was a systematic review of literature on the prevalence of PAD in community-based studies, and looked at 34 studies with 112,027 participants, of which 9,347 patients with PAD. Results showed that between 2000 and 2010, the number of individuals with PAD increased by over a quarter in low-income or middle-income countries (28.7 percent) and by 12.1 percent in high-income countries.

Further, the PAD burden has increased in every region, with the majority (140.8 million or 70 percent) in low-income or middle-income countries, primarily in southeast Asia (54.8 million) and western Pacific regions (45.9 million). Longer life expectancy, as well as changing lifestyles, are possible explanations for the dramatic rise in PAD rates, leading to a greater than 35 percent increase in cases older than 80 years, with PAD now affecting one in 10 people aged 70 years and one in six people older than 80 years worldwide.

Results also showed higher rates of PAD in men living in high-income countries than men in low-income or middle-income countries, but had opposite results for women with PAD, showing higher rates in low-income or middle-income countries, especially at younger ages. Additionally, the authors found evidence that confirms that many of the key risk factors for PAD are the same as those for other major cardiovascular disorders, and are both preventable and treatable.

The authors conclude that “interventions are urgently needed to reverse these trends both in low-income or middle-income countries and in high-income countries. The numbers are likely to grow substantially in the future, especially in low-income or middle-income countries, where much research is required on the social and economic burden as well as strategizes for optimum treatment and prevention,” they add.

“Despite its alarming prevalence and cardiovascular risk implications (people with PAD roughly have three times higher risk of heart attack and stroke), little attention has been paid to this disease,” said lead author Gerry Fowkes, MD, from the University of Edinburgh in the UK. “Our findings are a call to action.”

In an editorial comment, Alan T. Hirsch, MD, FACC, from the University of Minnesota Medical School and School of Public Health in Minneapolis, notes that “future progress in the improvement of global health will require a global strategic plan for PAD. When any disease affects more than 200 million people, it is time to take action to prevent and control its global burden.”

Clinical Topics: Vascular Medicine

Keywords: Prevalence, Stroke, Life Style, Life Expectancy, Income, Peripheral Arterial Disease, Risk Factors, Poverty


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