[Epidemiology of peripheral arterial disease in Germany. What is evident, what remains unclear?]

The prevalence of the peripheral arterial disease (PAD) varies with the analysed population and the screening method. The prevalence of the symptomatic PAD, derived from questionnaires, ranges from around 1% within the 50 years-old up to 5% within the 80 years-old. Due to the low specificity of such questionnaires this method has lost its relevance. In epidemiologic studies determination of the ankle/brachial index (ABI) is recommended for screening. ABI >0.9 indicates PAD. Based on the ABI the prevalence of the PAD in Germany in women aged 45-49 years is 2.3% and in men 2.6%. It increases to 10.4% and 15.2% in 70-75 years old women and men respectively. Real prevalence of PAD is assumed to be even higher, because ABI determination is biased to select people with more severe PAD and misses those with excellent collateral perfusion. Patients suffering from PAD with a chronic critical limb ischaemia (CLI) are characterised by the worst prognosis regarding limb salvage and mortality. Although the exact prevalence of CLI is unknown, it is assumed that CLI affects more than 2% of all PAD patients.