Spatiotemporal changes in the burden of lower extremity peripheral arterial disease and its socioeconomic impacts: an analysis based on Global Burden of Disease Study 2021

Lower extremity peripheral arterial disease (LEPAD) is a major cardiovascular condition impacting global health. This study aims to examine trends in LEPAD prevalence, incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. We examined the global burden of LEPAD from 1990 to 2021 across sexes, regions, and countries using data from the Global Burden of Disease Study. The analysis covered key indicators such as prevalence, incidence, mortality, and DALYs. To evaluate health disparities, we applied the concentration index and decomposition analysis, and employed a Bayesian age-period-cohort model to forecast future trends. Globally, from 1990 to 2021, the age-standardized prevalence rate (ASPR) declined by 0.52 (95% UI: -0.55 to -0.48), incidence rate (ASIR) by 0.49 (95% UI: -0.53 to -0.45), death rate (ASDR) by 1.7 (95% UI: -1.85 to -1.56), and DALY rate (ASLR) by 1.41 (95% UI: -1.51 to -1.31). In 2021, the greatest increases in prevalence and death were observed in low-middle SDI countries. Women showed higher incidence and prevalence than men. Although the global LEPAD burden has declined in standardized terms, the absolute number of cases continues to rise, primarily due to demographic and epidemiological transitions. LEPAD burden varies substantially across regions. Despite reductions in age-standardized rates from 1990 to 2021, the rising number of cases highlights the need for targeted interventions. Forecasts extending to 2036 offer valuable insights to support international public health planning and the effective distribution of resources.