The Case for Gulf Region-Specific Peripheral Artery Disease Trials: A Comprehensive Literature Review

Area of Science:

• Vascular Medicine
• Epidemiology
• Genetics

Background:

• Global peripheral artery disease (PAD) research is underrepresented and predominantly features white, Western populations.
• Existing landmark trials do not reflect the unique clinical landscape of the Gulf region.
• PAD prevalence in the Gulf region is high, reaching up to 13.7%.

Purpose of the Study:

• To highlight the underrepresentation of PAD research globally.
• To emphasize the unique epidemiological and genetic factors of PAD in the Gulf region.
• To advocate for region-specific PAD trials tailored to local populations.

Main Methods:

• Review of existing landmark PAD trials and their demographic limitations.
• Analysis of PAD prevalence and risk factors in the Gulf region, including diabetes, genetics, and consanguinity.
• Comparison of Gulf region data with Western populations.

Main Results:

• PAD prevalence in the Gulf region is significantly high (up to 13.7%).
• Gulf patients with PAD present at younger ages and have a disproportionately high diabetes burden (regional prevalence ~18%).
• Distinct genetic architectures, including high rates of consanguinity and familial hypercholesterolemia, are observed in the Gulf population.

Conclusions:

• Western-derived PAD data is not universally applicable to diverse populations.
• There is an urgent need for region-specific PAD trials in the Gulf.
• Future trials must incorporate local epidemiology, culturally adapted outcomes, and localized risk assessment models.