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Sharp increase in global prevalence of PAD
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The prevalence of peripheral arterial disease worldwide has increased by 23.5% in 10 years, according to a meta-analysis in The Lancet.
Researchers estimate that 202 million people worldwide had PAD in 2010, an increase from 164 million in 2000. Prevalence rates were similar among men and women and among those from high-income countries. However, 70% of PAD is now in those who live in low- and middle-income countries.
“Despite its alarming prevalence and cardiovascular risk implications, little attention has been paid to this disease. Our findings are a call to action,” researcher F. Gerald R. Fowkes, PhD, FRCPE, FFPH, of the Centre for Population Health Sciences, University of Edinburgh, United Kingdom, said in a press release.
The researchers reviewed 34 community-based studies (n=112,027; 9,347 with PAD). For the study, PAD was defined as ankle-brachial index ≤0.9. Using epidemiological modeling, the researchers classified prevalence rates that were age-specific and sex-specific in high-income countries and in the rest of the world. They then combined those prevalence rates with world population numbers from the U.N. for 2000 and 2010 to estimate the global prevalence of PAD. The researchers also analyzed ORs associated with 15 PAD risk factors to estimate the effect on people in high-income countries and in the rest of the world. They then predicted the PAD numbers in eight regions around the world using those risk factors and ORs.
According to results, the prevalence of PAD increased by 13.1% in high-income countries and 28.7% in the rest of the world.
In high-income countries, the prevalence of PAD for women aged 45 to 49 years was 5.28% (95% CI, 3.38-8.17). For men aged 45 to 49 years, the prevalence was 5.41% (95% CI, 3.41-8.49). For women aged 85 to 89 years, prevalence of PAD was 18.38% (95% CI, 11.16-28.76). For men aged 85 years to 89 years, the prevalence was 18.83% (95% CI, 12.03-28.25).
In the rest of the world, men had a lower prevalence of PAD than in high-income countries (2.89%; 95% CI, 2.04-4.07 at age 45 to 49 years; 14.94%; 95% CI, 9.58-22.56 at age 85 to 89 years). However, rates were higher in women than in men, particularly in younger age groups. The prevalence of PAD in women aged 45 to 49 years was 6.31% (95% CI, 4.86-8.15).
PAD risk factors included smoking, diabetes, hypertension and hypercholesterolemia.
“In the 21st century, PAD has become a global problem,” Fowkes and colleagues wrote. “Governments, nongovernmental organizations, and the private sector in low-income and medium-income countries need to address the social and economic consequences, and assess the best strategies for optimum treatment and prevention of this disease.”
Disclosure: Some researchers report financial relationships with AstraZeneca, Ironwood Pharmaceuticals and Pepsi.
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