Peripheral Artery Disease Rate Soars

Peripheral artery disease has risen at an alarming rate reaching over 200 million cases globally

/ Author:  / Reviewed by: Robert Carlson, M.D Chris Galloway, M.D. Beth Bolt, RPh

(RxWiki News) Peripheral artery disease (PAD) is a condition in which narrowed arteries reduce blood flow to the limbs. The disease not only causes leg pain, but also triples the risk for heart attack or stroke. And it seems rates of PAD have risen worldwide.

If you have high blood pressure, high cholesterol, smoke or have diabetes, you are at risk of getting PAD, according to the American Heart Association. With PAD, peripheral arteries — usually in the pelvis or legs — become narrowed or blocked by fatty deposits.

New scientific data indicate that 202 million people were living with PAD worldwide in 2010, up from about 164 million in 2000.

"Stop smoking and get regular exercise to lower your risk of PAD.  "

Gerry Fowkes, MD, professor of epidemiology at the University of Edinburgh in Scotland, and fellow researchers estimated that PAD is increasing around the world, with the majority of cases (about 70 percent or 140.8 million) now in low-income or middle-income countries. These countries are primarily in southeast Asia and western Pacific regions.

Since 2000, the number of individuals with PAD has climbed by over a quarter in low-income or middle-income countries and by about 13 percent in high-income countries. The high-income countries are mainly in Europe where there were 40.5 million cases in 2010.

The researchers based their estimates on 34 community-based studies on the incidence and prevalence of PAD.

Participants were tested for the disease using a common PAD screening method called ankle brachial index (ABI). This simple test measures the ratio of blood pressure at the ankle to that in the arm. The test is inexpensive and takes only a few minutes. It can be performed as part of a routine exam. Normally, the ankle pressure is at least 90 percent of the arm pressure, but with severe narrowing it may be less than 50 percent, according the American Heart Association.

The study authors noted that the dramatic rise in PAD may be driven by people living longer. Extended life expectancies have meant more health problems related to old age. For those older than 80, rates of PAD increased 35 percent over the decade. The disease affects 1 in 10 people aged 70 years and 1 in 6 people older than 80 years worldwide.

The Society of Interventional Radiology (SIR) states that PAD can happen to anyone, regardless of age, but it is most common in men and women over age 50. PAD affects 12 to 20 percent of Americans age 65 and older.

"Despite its alarming prevalence and cardiovascular risk implications [a roughly three times higher risk of heart attack and stroke], little attention has been paid to this disease,” said Dr. Fowkes in a press statement. “Our findings are a call to action.”

Dr. Fowkes, who is also director of the Wolfson Unit for Prevention of Peripheral Vascular Diseases, also discovered higher rates of PAD among men in high-income communities than men in low-/middle-income communities. In low-/middle-income communities, PAD may be more prevalent in women than in men, especially at younger ages.

Recommendations as to who should be screened for PAD may vary, but those who have symptoms may consider having an ankle-brachial index test.

The American Heart Association says that symptoms may include pain or cramping in the calves, thighs, hips or buttocks when walking, climbing stairs or exercising. The pain of PAD usually goes away when you stop exercising, although this may take a few minutes. Foot or toe wounds that don’t heal or heal very slowly are another sign. Also, a marked decrease in the temperature of your lower leg or foot particularly compared to the other leg or to the rest of your body is a symptom.

Left untreated, PAD can lead to gangrene and amputation, in addition to increasing the risk of stroke and heart attack.

This published report confirmed that the same risk factors that contribute to cardiovascular disease are culprits for PAD as well. These risk factors include hypertension (high blood pressure), high cholesterol, diabetes and smoking. These four major factors can be prevented and treated.

The Cleveland Clinic says that the three risk factors most strongly associated with PAD are advanced age (older than 60 years), cigarette smoking and diabetes.

"Future progress in the improvement of global health will require a global strategic plan for peripheral artery disease,” said Alan Hirsch, MD, professor of medicine in the Cardiovascular Division at the University of Minnesota Medical School in Minneapolis, in related commentary. “When any disease affects more than 200 million people, it is time to take action to prevent and control its global burden.”

This study was published on July 31 in The Lancet. The research was funded by Peripheral Arterial Disease Research Coalition (Europe).

Review Date: 
August 4, 2013
Last Updated:
August 6, 2013