Epidemiology of Peripheral Artery Disease
Peripheral artery disease (PAD) is a little-understood but significant health risk to the global population. We'll examine peripheral artery disease epidemiology, high-risk populations, and what can be done to manage the condition.
PAD is a major public health concern worldwide, affecting a many people. The frequency of PAD increases with age, with a higher burden observed in seniors.
The Global Burden of Disease Study reported that the global prevalence of PAD was approximately 202 million cases in 2019. This prevalence is expected to rise due to the growing aging population and the increasing rate of health factors, including nicotine use, high blood pressure, and diabetes.
Additionally, the increased use of recreational cannabis might cause greater occurrences of PAD—research indicates a link between marijuana use and the development of PAD in younger patients who weren’t at risk for atherosclerosis.
PAD prevalence in the United States population is roughly 3 to 7%—an estimated 8.5 million people. However, people over 65 represent the most significant portion of those affected by the condition. Between 12% and 20% of people in the United States over 65 are affected by PAD.
Seniors and PAD
Approximately 20% of people over 70 are affected by PAD. Nearly 80% will have few or no symptoms.
A small percentage of this population will require minor or radical surgery (revascularization, bypass surgery, or limb removal). PAD symptoms can be particularly devastating for those with co-occurring medical disorders like diabetes or cardiovascular disease.
One of the main reasons why seniors are more susceptible to PAD is the gradual accumulation of deposits, known as plaque, in the arteries. This condition, called atherosclerosis, occurs naturally as part of the aging process. Over time, these plaques can restrict blood flow and lead to the development of PAD.
Moreover, seniors may have other underlying health conditions that can lead to the progression of PAD. Such conditions include diabetes, high blood pressure, elevated LDL cholesterol levels, and smoking, all more prevalent in older individuals. These factors can further accelerate peripheral artery disease.
Furthermore, seniors often have a reduced physical activity level compared to younger individuals. Lack of regular exercise can contribute to the development of PAD by promoting weight gain, increasing cholesterol levels, and weakening the muscles and blood vessels in the legs.
Race and PAD
PAD is more prevalent among non-Hispanic Black people (an estimated 7.9%) than non-Hispanic White people (an estimated 3%).
According to the American Heart Association, close to one-third of adults of African descent are at risk for developing PAD. One in five Hispanic or White adults are at risk for PAD.
Non-White adults with PAD experience a higher risk of serious complications. Black PAD patients are statistically more likely to require lower limb amputation than White patients.
Additionally, Black patients are at a greater risk for death after amputation. Between 45% and 60% of patients from underserved racial and ethnic groups will die within five years of the procedure.
Comorbidities and PAD
In the United States, primary care evaluations have indicated that 50% of individuals diagnosed with PAD also have concurrent coronary artery or cerebrovascular disease.
The prognosis for patients with PAD and coexisting coronary artery disease, cerebrovascular disease, or diabetes can be more challenging than those with PAD alone. These additional conditions increase the risk of complications and can significantly impact the overall prognosis.
An estimated one-third of people with diabetes over 50 also have PAD.
Patients with PAD and diabetes face additional challenges in managing their condition. Diabetes can accelerate the progression of atherosclerosis, leading to more severe arterial blockages. Poorly controlled blood sugar levels can further impair blood transfer to the lower extremities, increasing the risk of complications like non-healing ulcers and lower limb amputations.
While a sizable portion of people in the United States either have PAD or are at considerable risk for PAD, there is an extremely low awareness of the condition compared to conditions like Alzheimer's, which affects 6.5 million Americans. According to research published in 2007, only 26% of U.S. survey respondents had heard of PAD.
Various risk factors influence the development of PAD. Multiple issues are associated with an increased risk of developing PAD.
For instance, smoking is the most significant preventable risk factor for PAD. Other important risk factors include
- Diabetes
- Hypertension
- High LDL cholesterol
- Physical inactivity
- High body fat
- Family history of cardiovascular disease
Georgia Endovascular: Atlanta's Trusted Vascular Specialists
Georgia Endovascular is a trusted resource for individuals seeking to manage peripheral artery disease. With a focus on patient care, a wide range of services, and a commitment to innovation, Georgia Endovascular strives to provide the highest quality care to each and every patient.
If you have concerns about your risk for PAD, please contact our helpful representatives in Atlanta to schedule an evaluation today.
