ORIGINAL RESEARCH article

Front. Cardiovasc. Med.

Sec. Cardiovascular Epidemiology and Prevention

Recent Findings on the Global, Regional, and National Burden of Lower Extremity Peripheral Arterial Disease in the Elderly (1990–2021): An Analysis Based on the Global Burden of Disease Study 2021

  • 1. Department of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai, China

  • 2. Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China

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Abstract

Introduction: Lower extremity peripheral arterial disease (LEPAD) significantly impacts the elderly population, with increasing prevalence globally. This study analyzes the global, regional, and national burden of LEPAD in individuals aged 60 and above from 1990 to 2021, using data from the Global Burden of Disease Study 2021. Methods: We examined age-standardized prevalence rates (ASPR), incidence rates (ASIR), and disability-adjusted life years (DALYs) across 204 countries. Trends over time were assessed using Estimated Annual Percentage Change (EAPC), and future projections were made through a Bayesian age-period-cohort model. Results: In 2021, the elderly population experienced 87.5 million LEPAD cases, a 105.5% increase since 1990. ASPR declined slightly (EAPC: -0.52) despite rising absolute cases, reflecting aging populations. High SDI regions had the highest prevalence but also the greatest reductions over time. Regional disparities were notable, with Eastern and Central Europe facing the highest DALYs. Projections to 2040 suggest continued increases in LEPAD burden, with gender disparities persisting. Conclusion: LEPAD remains a growing global health challenge, driven by aging populations. Targeted interventions are needed, particularly in low-middle SDI regions, to address the escalating burden of LEPAD among the elderly.

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Keywords

Disability-adjusted life years, Global burden of disease, Incidence, lower extremity peripheral arterial disease, Prevalence

Received

19 August 2025

Accepted

28 January 2026

Copyright

© 2026 Yang, Fang, Wang, Li, Xie, Zhou, Ding, Zhou and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yong Ding; Min Zhou; Zhenyu Shi

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