Peripheral arterial disease prevalence

Peripheral arterial disease affects eight million Americans and is associated with significant morbidity and mortality. ₁

A study from the NHANES 1999–2000 data found that PAD affects approximately 5 million adults. Prevalence increases dramatically with age and disproportionately affects blacks. ₂ However, the measurement of systolic blood pressure utilizing the right arm only and the omission of queries for surgical procedures to correct PAD in this study led to an underestimate of the true PAD prevalence. Experts in the field generally agree that PAD affects approximately 8 million Americans. ₃

PAD affects 12-20 percent of Americans age 65 and older. Despite its prevalence and cardiovascular risk implications, only 25 percent of PAD patients are undergoing treatment. ₄

In the general population, only about 10 percent of persons with PAD have the classic symptoms of intermittent claudication (IC). About 40 percent do not complain of leg pain, while the remaining 50 percent have a variety of leg symptoms different from classic claudication. ₅ However, in an older, disabled population of women, as many as two-thirds of individuals with PAD had no exertional leg symptoms. ₆

The risk factors for PAD are similar to those for coronary heart disease, although diabetes and cigarette smoking are particularly strong risk factors for PAD. ₇

Persons with PAD have impaired function and quality of life. This is true even for persons who do not report leg symptoms.₈

PAD is a marker for systemic atherosclerotic disease. Persons with PAD, compared to those without, have four-to-five times the risk of dying of a cardiovascular disease event, resulting in two-to-three times higher total mortality risk.₉

In the Framingham Heart Study (FHS), the incidence of PAD was based on symptoms of intermittent claudication (IC) in subjects ages 29-62. Annual incidence of IC per 10,000 subjects at risk rose from six in men and three in women ages 30-44 to 61 in men and 54 in women ages 65-74. ₁₀ IC incidence has declined since 1950, but mortality has remained high and unchanged. ₁₁

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Several studies have evaluated both symptomatic and asymptomatic PAD using the ankle-brachial index (ABI). The prevalence of asymptomatic PAD was 25.5 percent among 1,537 participants of the Systolic Hypertension in the Elderly Program (SHEP).