Global Epidemiology of Lower Extremity Artery Disease in the 21st Century (2000-2021): a Systematic Review and Meta-analysis.

Among 1418 references, 38 studies (127,961 participants) were retained. The global prevalence in adults, mostly ≥40 years, was estimated at 9.7% (95%CI: 7.1-12.4), higher in women (10.2%) than in men (8.8%), increasing sharply with age. The highest prevalence was found in South-Center Asia (14.5%) and the lowest in North America (5.6%). Significant associations were found between LEAD and current- (odds-ratio (OR) = 1.9, 95%CI: 1.4-2.5) and past-smoking (OR = 1.6, 95%CI: 1.3-1.9), and between LEAD and diabetes (OR = 2.3, 95%CI: 2.0-2.8). Hypertension was significantly associated with LEAD (OR = 2.3, 95%CI: 1.9-2.8) and in particular in South America (OR = 4.0). Obesity (OR = 1.5, 95%CI: 1.2-1.8) and hypercholesterolemia ≥200 mg/dL (OR = 1.9, 95%CI:1.3-2.8) were also significantly associated with LEAD. Conclusion: This meta-analysis highlights a currently high prevalence of LEAD worldwide, with substantial differences in global regions and between sexes. The strongest associations were found with metabolic risk factors.