Soaring rates of PAD warrant global attention

Edinburgh, Scotland - More than 200 million people worldwide were living with peripheral artery disease (PAD) in 2010, a new review suggests [1]. More than two-thirds of these are living in low- and middle-income countries, including more than 55 million in Southeast Asia and 46 million in the western Pacific region.

According to Dr F Geral Fowkes (University of Edinburgh, Scotland) and colleagues, the most alarming finding from their study is the rate at which the prevalence of PAD is increasing. In the past 10 years, the number of people with PAD has risen by 23.5%. And strikingly, the rise in PAD has been twice as high in low-/middle-income countries (a 28.7% increase) as compared with the increase in high-income countries (13.1%).

"Little attention has been paid to this disease," Fowkes warned in a press statement accompanying the study, published online July 31, 2013 in the Lancet [1]. This is despite the fact that PAD is the third leading cause of atherosclerotic cardiovascular morbidity, after coronary artery disease and stroke, the authors note.

Fowkes et al conducted a systematic literature review, looking at community-based studies since 1997. They used epidemiological modeling to define age-specific and sex-specific prevalence rates in high-income and low-/middle-income countries and calculated PAD prevalence using population numbers from 2000 and 2010.

Among the other findings of their review:

• The prevalence of PAD in high-income countries is similar between men and women, both at younger ages (45-49 years; approximately 5%) and older ages (85-89; approximately 18%).
• In low-/middle-income countries, women have higher PAD rates than men, especially at younger ages.
• Prevalence of PAD is lower in men but higher in women in low-/middle-income countries as compared with high-income countries at both younger and older ages.
• Smoking was the most important risk factor for PAD, followed by diabetes, hypertension, and hypercholesterolemia.

Fowkes and colleagues say their paper should serve as a call to action for a disease that has truly become a global problem.

"In view of the association of peripheral artery disease with loss of mobility, functional decline, and cardiovascular events, this dramatic increase in the number of people living with peripheral artery disease represents a major public-health challenge," they write. "Interventions are urgently needed to reverse these trends in both [low-/middle-income countries] and [high-income countries]. The numbers are likely to grow substantially in the future, especially in [low-/middle-income countries], where much research is required on the social and economic burden as well as strategies for optimum treatment and prevention."

Source: www.theheart.org