Global and national burden of peripheral arterial disease from 1990 to 2021: a systematic analysis of global burden of disease study 2021.

Background: Peripheral arterial disease (PAD) poses a significant global health challenge. Comprehensive global assessments of the disease burden of PAD remain limited. The study utilizes the Global Burden of Disease (GBD) framework to analyze global trends in PAD systematically from 1990 to 2021. Furthermore, future trends through to 2035 are projected. Methods: Data of PAD from the GBD Study 2021 was employed, covering incidence of PAD, mortality rates, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (ASDALYs) across 204 countries and regions from 1990 to 2021. Trend projection up to the year 2035 was performed with the Bayesian age-period-cohort model. Results: Globally, the ASIR, ASMR and ASDALYs of PAD exhibited a downward trend in the years studied. The age analysis showed that the proportion of the population aged 70 and over with PAD exceeded 90%, whether in terms of ASIR, ASMR, or ASDALYs. These metrics showed an upward trend for people with PAD under 70 years old. The primary risk factor for PAD was smoking. Our projections show that, from 2022 to 2035, the ASIR (115.2-110.5), ASMR (0.8-0.7) and ASDALYs (18.5-16.5) of PAD will all follow a downward trend. Conclusions: Overall, the global disease burden of PAD shows a downward trend. However, it exhibits an upward trend in regions with low and middle-low socio-demographic index. The cessation of smoking should be the primary public health measure to continue this trend.