Forecasting the Global Burden of Peripheral Artery Disease from 2021 to 2050: A Population-Based Study

Vascular disease is the leading cause of death worldwide. Predicting the burden of vascular disease and identifying modifiable key risk factors are critical for developing effective prevention strategies. This study aimed to project the global and regional burden of peripheral artery disease (PAD) from 2021 to 2050, with a specific focus on the impact of modifiable key risk factors and the potential benefits of their management. Compared to the 2021 Global Burden of Disease Study (GBD 2021), the number of PAD cases worldwide is projected to increase by 220% by 2050, reaching a staggering 360 million (95% uncertainty interval, 270 to 450). Age-standardized mortality is expected to double, while disability-adjusted life years (DALYs) are forecasted to rise from 19.7 to 33.1 per 100,000. Among individuals aged ≥65 years, PAD prevalence is projected to surge to 21.7% in women and 14.8% in men. Moreover, over 50% of PAD cases are expected to occur in low- and middle-income countries (LMICs). Metabolic diseases are anticipated to be the primary drivers of the rising PAD burden, with diabetes playing a key role in increasing PAD prevalence and severity. By effectively managing metabolic risk factors, age-standardized prevalence could be reduced by 36%, mortality by 17%, and DALYs by 10%. As metabolic risks, particularly diabetes, continue to rise alongside population aging, the global PAD burden is expected to increase substantially, especially in LMICs. Importantly, proactive metabolic risk management strategies have the potential to markedly alleviate the burden of vascular disease and reduce the growing geographic health disparities.