Peripheral Artery Disease Burden in Different Development Regions: Based on GBD 2021

Abstract

Background

Peripheral artery disease (PAD) is a major global health problem with marked regional disparities. Updated estimates are needed to better characterize these differences and inform priority-setting in prevention and management.

Methods

Using GBD 2021 data, we estimated PAD prevalence, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) in High-income North America (HINA), the Caribbean, and Sub-Saharan Africa (SSA). Outcomes were reported as counts, crude rates, and age-standardized rates (ASRs), with stratification by sex, socio-demographic index (SDI), and age. Temporal trends from 1990 to 2021 and risk factor–attributable DALYs were also assessed.

Results

From 1990 to 2021, PAD cases increased by 72% in HINA, 127% in the Caribbean, and 137% in SSA, while DALYs increased by 84%, 168%, and 203%, respectively. Prevalence and DALY ASRs declined slightly in HINA, increased moderately in the Caribbean, and rose more markedly in SSA. Women showed higher prevalence and YLD burden, whereas men had higher YLL and mortality. Tobacco use and high fasting plasma glucose contributed more prominently to the attributable burden in HINA and the Caribbean, whereas high systolic blood pressure and kidney dysfunction were more prominent in SSA. PAD burden increased substantially after age 60 and peaked in the oldest age groups.

Conclusion

PAD burden continues to rise, with SSA showing the least favorable age-standardized trends. These findings highlight substantial regional heterogeneity and may help identify priorities for earlier detection, risk-factor control, and long-term PAD management, particularly in lower-resource settings.