New Insights on Peripheral Artery Disease Highlight Urgent Need for Action

A comprehensive three-part series published on September 22 in The Lancet sheds light on the escalating global burden of peripheral artery disease (PAD), emphasizing the urgent need for enhanced diagnosis, treatment, and access to care. The series delves into the disease's epidemiology, management strategies, and future challenges, underscoring the critical importance of prevention and modification of risk factors.

The first paper, authored by Christian-Alexander Behrendt, MD, and colleagues, describes PAD as a largely unrecognized and undertreated condition that affects over 113 million people aged 40 and older worldwide. Despite its significant impact, PAD can often remain asymptomatic for years, with advanced stages linked to a mortality rate of 30-50% over five years, surpassing that of many cancers. The authors point to aging populations, smoking, diabetes, and other cardiovascular risk factors as primary contributors to the increasing prevalence of PAD, which is often associated with polyvascular disease, further elevating cardiovascular risks.

In the second paper led by Riikka Tulamo, PhD, the authors stress that modifying risk factors should be central to PAD management. This includes initiatives such as smoking cessation, exercise, and proper management of blood pressure and diabetes. Supervised exercise therapy is highlighted as a particularly effective treatment for intermittent claudication, yet access to such programs is limited, with only 59% of European countries offering them. The authors also note significant regional variations in care, with treatment approaches differing widely across U.S. centers.

The third paper, authored by Jonathan Golledge, MChir, and colleagues, explores the severe consequences of advanced PAD, including chronic pain, mobility issues, and heightened risks of cardiovascular events. A systematic review indicated that PAD patients are 1.82 times more likely to experience falls, with over 40% of U.S. patients with chronic limb-threatening ischemia requiring assistance for mobility. The authors highlight persistent disparities in PAD outcomes, particularly among underserved populations who often face delayed diagnoses and reduced access to specialized care.

In light of these findings and the recognition of PAD Awareness Month, healthcare professionals are encouraged to review the 2024 ACC/AHA PAD Guideline and utilize educational resources to enhance awareness and early intervention for this critical condition, which significantly affects cardiovascular health and quality of life globally.