Global Prevalence and Impact of PAD: A Literature Review
February 2, 2026
Peripheral arterial disease (PAD) is a wide- spread condition affecting millions of peo- ple worldwide. According to a systematic review and meta-analysis by Song et al. (2019), the global prevalence of PAD is estimated to be around 11% in the general population, with a higher prevalence of 19% among individuals aged 60 years and older.
The number of people affected by PAD is projected to increase as populations age, thereby posing a significant burden on healthcare systems. In the US, PAD affects an estimated 8.5 million Americans, and its prevalence increases with age. According to the PAD National Action Plan published by AHA, PAD is often underdiagnosed and undertreated, with many people unaware of the condition and its potential complications.2
Lifestyle modifications such as smoking cessation, regular exercise, and a healthy diet can help prevent PAD and its complications. The ankle-brachial index (ABI) is a simple and effective screening tool for PAD, but it is underutilized in clinical practice. Lifestyle modifications, medication, and revascularization procedures such as angioplasty and bypass surgery are all options for treating PAD, depending on the severity of the condition.
In the US, PAD disproportionately affects certain populations, including African Americans, Hispanics, and Native Americans, and these disparities need to be addressed. Healthcare providers and the general public need more education and awareness about PAD, its risk factors, and the importance of early detection and treatment.2
The development of PAD is commonly associated with several modifiable and non-modifiable risk factors. Major modifiable risk factors include smoking, diabetes, hypertension, and dyslipidemia, while non-modifiable risk factors include age, sex, and family history of cardiovascular disease.3 Early identifi- cation and management of these risk factors can potentially reduce the incidence and severity of PAD.
Untreated or undiagnosed PAD can lead to serious clinical consequences. Patients with PAD are at an increased risk of developing critical limb ischemia (CLI), which can result in non-healing ulcers, gangrene,and ultimately limb amputation.4 Additionally, PAD is associated with an increased risk of cardiovascular events such as myocardial infarction, stroke, and cardiovascular death.5
The financial burden associated with PAD is substantial. A study by Mahoney et al. (2014) estimated that the total annual costs for PAD-related hospitalizations, outpatient visits, and medications in the United States alone were over $21 billion.6 Moreover, these costs are expected to rise as the prevalence of PAD continues to increase. Early detection and intervention can potentially reduce healthcare costs associated with PAD by preventing or delaying the onset of complications.
Despite the significant impact of PAD on patients and healthcare systems, many cases remain undiag- nosed and untreated. Factors contributing to this issue include a lack of awareness among healthcare providers and patients, underutilization of diagnostic tests, and suboptimal management of risk factors.7 The introduction of innovative, accurate, and accessible diagnostic tools, such as SMART ABI, can potentially help address these gaps and improve PAD detection and management.
References
1 Song, P., Rudan, D., Zhu, Y., Fowkes, F.J.I., Rahimi, K., Fowkes, F.G.R., & Rudan, I. (2019). Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. The Lancet Global Health, 7(8), e1020-e1030.
2 AHA PAD National Action Plan (2022)
3 Gerhard-Herman, M.D., Gornik, H.L., Barrett, C., Barshes, N.R., Corriere, M.A., Drachman, D.E., & American Heart Association Council on Peripheral Vascular Disease. (2017). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 135(12), e726-e779.
4 Norgren, L., Hiatt, W.R., Dormandy, J.A., Nehler, M.R., Harris, K.A., & Fowkes,
5 Criqui, M. H., & Aboyans, V. (2015). Epidemiology of peripheral artery disease. Circulation Research, 116(9), 1509-1526.
6 Mahoney, E. M., Wang, K., Keo, H. H., Duval, S., Smolderen, K. G., Cohen, D. J., … & Beltrame, J. (2014). Vascular hospitalization rates and costs in patients with peripheral artery disease in the United States. Circula- tion: Cardiovascular Quality and Outcomes, 7(6), 814-821.
7 Hirsch, A. T., Criqui, M. H., Treat-Jacobson, D., Regensteiner, J. G., Creager, M. A., Olin, J. W., & Hiatt, W. R. (2001). Peripheral arterial disease detection, awareness, and treatment in primary care. JAMA, 286(11), 1317-1324.