Secular trends in the epidemiologic patterns of peripheral artery disease and risk factors in China from 1990 to 2019: Findings from the global burden of disease study 2019

An understanding of the epidemiologic patterns of peripheral artery disease is essential in public health policy-making. We aimed to assess secular trends in the epidemiologic patterns and risk factors of peripheral artery disease from 1990 to 2019 in China.We extracted data on prevalence, incidence, death, and disability-adjusted life years (DALYs) due to peripheral artery disease from the Global Burden of Disease study 2019. In addition, risk factors for peripheral artery disease were reported.The age-standardized prevalence of peripheral artery disease significantly increased from 1330.42 to 1423.78 per 100,000 population, with an average annual percentage change (AAPC) of 0.16 [95% confidence interval (CI), 0.07 to 0.24] from 1990 to 2019 in China. In addition, the age-standardized mortality rate significantly increased, with an AAPC of 0.62 (95% CI, 0.54 to 0.7), contrasting with the significantly declining trend in age-standardized DALYs (AAPC, -0.45; 95% CI, -0.52 to -0.39) between 1990 and 2019. The age-standardized prevalence was almost three times higher in females than males [2022.13 (95% CI: 1750 to 2309.13) vs. 744.96 (95% CI: 644.62 to 850.82) per 100,000 population] in 2019. The age-specific incidence significantly increased in individuals aged 40-44, 45-49, 50-54, 55-59, and 60-64 years groups but decreased in 70-74, 75-79, and 80-84 years groups. The age and period effects showed that the relative risks of incident peripheral artery disease increased with age and time. The cohort assessment showed that the incidence decreased in successive birth cohorts. Smoking was identified as the risk factor that contributed the most to age-standardized DALYs of peripheral artery disease in 2019.The burden of peripheral artery disease showed unexpected patterns that varied by age, sex, and year in China. More attention should be given to addressing the increasing incidence among middle-aged individuals and mortality among males.