{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:01:11Z","timestamp":1786114871186,"version":"build-2736575974"},"reference-count":51,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Angiol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Peripheral artery disease (PAD) affects more than 230 million people worldwide, with a disproportionate burden in low- and middle-income countries. PAD is more common in the elderly population; prevalence increases significantly from about 10% in individuals aged 55 to 59 years to 60% among people aged \u2265 85 years. Racial and ethnic disparities are evident in PAD, as Black individuals have nearly double the prevalence of PAD compared with non-Hispanic White individuals. Chronic limb-threatening ischemia, the most advanced clinical manifestation of PAD that affects approximately 1.3% of adults aged \u226540 years is associated with an annual risk of 20% for both mortality and amputation. Conventional modifiable risk factors, including smoking, diabetes mellitus, hypertension, and dyslipidemia, account for roughly 75% of PAD cases, with the most common association being tobacco use and diabetes. The PAD prevalence has almost doubled between 1990 and 2021 globally. Despite its high prevalence, PAD remains underdiagnosed, as only about half of physicians establish the diagnosis despite symptoms suggestive of PAD. This underrecognition contributes to inadequate risk factor management and increases the risk of major adverse cardiovascular and limb events. Therefore, the early diagnosis of PAD remains essential. Emerging artificial intelligence\u2013based approaches are promising for earlier detection of high-risk patients; however, traditional strategies, such as focusing on modifiable risk factor controls, are still the most important step to reduce cardiovascular and limb complications associated with PAD.<\/jats:p>","DOI":"10.1055\/a-2832-4161","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T01:19:22Z","timestamp":1774055962000},"page":"163-169","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of Peripheral Artery Disease, Risk Factors, and Trends"],"prefix":"10.1055","volume":"35","author":[{"given":"Zeynep","family":"Yukselen","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center at El Paso, Texas, Unites 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Med"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"e171","DOI":"10.1161\/CIR.0000000000001005","article-title":"Lower extremity peripheral artery disease: contemporary epidemiology, management gaps, and future directions: a scientific statement from the American Heart Association","volume":"144","author":"M H Criqui","year":"2021","journal-title":"Circulation"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1161\/CIR.0000000000001153","article-title":"Health disparities in peripheral artery disease: a scientific statement from the American Heart Association","volume":"148","author":"M A Allison","year":"2023","journal-title":"Circulation"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1055\/s-0031-1278244","article-title":"Peripheral arterial disease: epidemiology, natural history, diagnosis and treatment","volume":"16","author":"G Dhaliwal","year":"2007","journal-title":"Int J Angiol"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1177\/0003319712470966","article-title":"Critical and acute limb ischemia: an overview","volume":"65","author":"N Falluji","year":"2014","journal-title":"Angiology"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1016\/j.jvs.2014.03.290","article-title":"Epidemiology of peripheral arterial disease and critical limb ischemia in an insured national population","volume":"60","author":"M R Nehler","year":"2014","journal-title":"J Vasc Surg"},{"issue":"16","key":"ref8","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1016\/j.jacc.2016.02.040","article-title":"Nationwide trends of hospital admission and outcomes among critical limb ischemia patients: from 2003-2011","volume":"67","author":"S Agarwal","year":"2016","journal-title":"J Am Coll 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Meijer","year":"1998","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1161\/HYPERTENSIONAHA.113.01925","article-title":"Metabolic syndrome and risk of incident peripheral artery disease: the cardiovascular health study","volume":"63","author":"P K Garg","year":"2014","journal-title":"Hypertension"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1093\/aje\/kwi167","article-title":"Ankle-brachial index and subclinical cardiac and carotid disease: the multi-ethnic study of atherosclerosis","volume":"162","author":"M M McDermott","year":"2005","journal-title":"Am J Epidemiol"},{"issue":"24","key":"ref14","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1016\/j.jacc.2024.02.013","article-title":"2024 ACC\/AHA\/AACVPR\/APMA\/ABC\/SCAI\/SVM\/SVN\/SVS\/SIR\/VESS guideline for the management of lower extremity peripheral artery disease: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"83","author":"H L Gornik","year":"2024","journal-title":"J Am Coll Cardiol"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1046\/j.1532-5415.2003.51061.x","article-title":"Sex differences in peripheral arterial disease: leg symptoms and physical functioning","volume":"51","author":"M M McDermott","year":"2003","journal-title":"J Am Geriatr Soc"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.jvs.2006.10.032","article-title":"Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"45","author":"V Aboyans","year":"2007","journal-title":"J Vasc Surg"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.jvs.2009.05.061","article-title":"Ethnicity and risk factors for change in the ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis","volume":"50","author":"M A Allison","year":"2009","journal-title":"J Vasc Surg"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/S0140-6736(13)61576-7","article-title":"The global pandemic of peripheral artery disease","volume":"382","author":"A T Hirsch","year":"2013","journal-title":"Lancet"},{"issue":"16","key":"ref19","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1001\/jama.2012.13415","article-title":"Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men","volume":"308","author":"M M Joosten","year":"2012","journal-title":"JAMA"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2S","DOI":"10.1016\/j.jvs.2014.12.009","article-title":"Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and 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Inter-society consensus for the management of peripheral arterial disease (TASC II)","volume":"45","author":"L Norgren","year":"2007","journal-title":"J Vasc Surg"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1097\/01.ASN.0000119574.27772.FD","article-title":"Renal insufficiency and the risk of lower extremity peripheral arterial disease: results from the Heart and Estrogen\/Progestin Replacement Study (HERS)","volume":"15","author":"A M O'Hare","year":"2004","journal-title":"J Am Soc Nephrol"},{"issue":"19","key":"ref23","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1001\/jama.285.19.2481","article-title":"Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease","volume":"285","author":"P M Ridker","year":"2001","journal-title":"JAMA"},{"issue":"02","key":"ref24","doi-asserted-by":"crossref","first-page":"82","DOI":"10.2174\/1871525717666190904151856","article-title":"Epidemiology and adverse consequences of hookah\/waterpipe use: a systematic review","volume":"17","author":"R Pratiti","year":"2019","journal-title":"Cardiovasc Hematol Agents Med Chem"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1016\/j.jvs.2004.08.049","article-title":"Influence of smoking on incidence and prevalence of peripheral arterial disease","volume":"40","author":"E M Willigendael","year":"2004","journal-title":"J Vasc Surg"},{"issue":"03","key":"ref26","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/1358863X9700200314","article-title":"The role of tobacco cessation, antiplatelet and lipid-lowering therapies in the treatment of peripheral arterial disease","volume":"2","author":"A T Hirsch","year":"1997","journal-title":"Vasc Med"},{"issue":"14","key":"ref27","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.jacc.2015.06.1349","article-title":"The contribution of tobacco use to high health care utilization and medical costs in peripheral artery disease: a state-based cohort analysis","volume":"66","author":"S Duval","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"04","key":"ref28","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.jacc.2019.05.049","article-title":"Cigarette smoking, smoking cessation, and long-term risk of 3 major atherosclerotic diseases","volume":"74","author":"N Ding","year":"2019","journal-title":"J Am Coll Cardiol"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.beem.2008.10.015","article-title":"Peripheral and cerebrovascular atherosclerotic disease in diabetes mellitus","volume":"23","author":"D Mukherjee","year":"2009","journal-title":"Best Pract Res Clin Endocrinol 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Cardiol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"h4865","DOI":"10.1136\/bmj.h4865","article-title":"Usual blood pressure, peripheral arterial disease, and vascular risk: cohort study of 4.2 million adults","volume":"351","author":"C A Emdin","year":"2015","journal-title":"BMJ"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"Global vascular guidelines on the management of chronic limb-threatening ischemia","volume":"58","author":"M S Conte","year":"2019","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"12","key":"ref35","doi-asserted-by":"crossref","first-page":"3058","DOI":"10.1161\/ATVBAHA.112.255521","article-title":"Lipoprotein(a) and risk of coronary, cerebrovascular, and peripheral artery disease: the EPIC-Norfolk prospective population study","volume":"32","author":"D Gurdasani","year":"2012","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"171","DOI":"10.2174\/0115701611267835231210054909","article-title":"Lipoprotein (a) as a biomarker for cardiovascular diseases and potential new therapies to mitigate risk","volume":"22","author":"D Mukherjee","year":"2024","journal-title":"Curr Vasc Pharmacol"},{"issue":"21","key":"ref37","doi-asserted-by":"crossref","first-page":"2330","DOI":"10.1161\/CIRCULATIONAHA.118.035432","article-title":"Lipoprotein particle profiles, standard lipids, and peripheral artery disease incidence","volume":"138","author":"A W Aday","year":"2018","journal-title":"Circulation"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.jss.2024.12.038","article-title":"The relationship between body mass index and peripheral artery disease: insights from the National Health and Nutrition Examination Survey and Mendelian Randomization Analysis","volume":"306","author":"W Bai","year":"2025","journal-title":"J Surg Res"},{"issue":"01","key":"ref39","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1161\/ATVBAHA.114.304161","article-title":"Association between physical activity and peripheral artery disease and carotid artery stenosis in a self-referred population of 3 million adults","volume":"35","author":"R A Stein","year":"2015","journal-title":"Arterioscler Thromb Vasc Biol"},{"issue":"21","key":"ref40","doi-asserted-by":"crossref","first-page":"e013534","DOI":"10.1161\/JAHA.119.013534","article-title":"Physical activity and subsequent risk of hospitalization with peripheral artery disease and critical limb ischemia in the ARIC study","volume":"8","author":"Y Lu","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"01","key":"ref41","doi-asserted-by":"crossref","first-page":"270","DOI":"10.3390\/nu13010270","article-title":"Mechanisms of dietary sodium-induced impairments in endothelial function and potential countermeasures","volume":"13","author":"J C Patik","year":"2021","journal-title":"Nutrients"},{"issue":"02","key":"ref42","doi-asserted-by":"crossref","first-page":"H454","DOI":"10.1152\/ajpheart.00158.2008","article-title":"Mechanisms of lead-induced hypertension and cardiovascular disease","volume":"295","author":"N D Vaziri","year":"2008","journal-title":"Am J Physiol Heart Circ Physiol"},{"issue":"10","key":"ref43","doi-asserted-by":"crossref","first-page":"e1553","DOI":"10.1016\/S2214-109X(23)00355-8","article-title":"Global burden of peripheral artery disease and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"11","author":"M S Kim","year":"2023","journal-title":"Lancet Glob Health"},{"issue":"03","key":"ref44","doi-asserted-by":"crossref","first-page":"293","DOI":"10.2174\/157016110791112304","article-title":"The importance of early diagnosis and treatment in peripheral arterial disease: insights from the PARTNERS and REACH registries","volume":"8","author":"D Mukherjee","year":"2010","journal-title":"Curr Vasc Pharmacol"},{"issue":"03","key":"ref45","doi-asserted-by":"crossref","first-page":"e031880","DOI":"10.1161\/JAHA.123.031880","article-title":"Artificial intelligence of arterial Doppler waveforms to predict major adverse outcomes among patients evaluated for peripheral artery disease","volume":"13","author":"R D McBane II","year":"2024","journal-title":"J Am Heart Assoc"},{"issue":"10","key":"ref46","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.3390\/biomedicines9101456","article-title":"Artificial intelligence identifies an urgent need for peripheral vascular intervention by multiplexing standard clinical parameters","volume":"9","author":"K Sonnenschein","year":"2021","journal-title":"Biomedicines"},{"issue":"21","key":"ref47","doi-asserted-by":"crossref","first-page":"2188","DOI":"10.1001\/jama.2021.2126","article-title":"Lower extremity peripheral artery disease without chronic limb-threatening ischemia: a review","volume":"325","author":"T S Polonsky","year":"2021","journal-title":"JAMA"},{"issue":"01","key":"ref48","doi-asserted-by":"crossref","first-page":"19898","DOI":"10.1038\/s41598-023-47028-5","article-title":"Global disease burden and its attributable risk factors of peripheral arterial disease","volume":"13","author":"Y You","year":"2023","journal-title":"Sci Rep"},{"issue":"25","key":"ref49","first-page":"01238","article-title":"Global burden, health disparities, and projections of lower extremity peripheral artery disease: insights from global burden of disease, injuries, and risk factors study 2021","volume":"S1078-5884","author":"H Wen","year":"2025","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"22","key":"ref50","first-page":"2167","article-title":"Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators. Global, regional, and national burden of cardiovascular diseases and risk factors in 204 countries and territories, 1990\u20132023","volume":"86","author":"Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"06","key":"ref51","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1136\/jech.47.6.475","article-title":"Physical activity and risk of peripheral arterial disease in the general population: Edinburgh Artery Study","volume":"47","author":"E Housley","year":"1993","journal-title":"J Epidemiol Community Health"}],"container-title":["International Journal of Angiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2832-4161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T22:31:33Z","timestamp":1785969093000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2832-4161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":51,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2026,8,5]]},"published-print":{"date-parts":[[2026,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2832-4161","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1061-1711","1615-5939"],"issn-type":[{"value":"1061-1711","type":"print"},{"value":"1615-5939","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]}}}