Burden of lower-limb peripheral arterial disease in China and its comparison with global estimates, 1990–2021: analysis of global burden of disease (GBD) data by sex and age group

Lower Peripheral arterial disease refers to ischemic diseases caused by atherosclerotic stenosis or occlusion of the arteries in the lower limbs. This study analyzed the disease burden (incidence, prevalence, mortality, and disability-adjusted life years [DALYs]) of lower extremity arterial diseases in China from 1990 to 2021, and compared with corresponding global estimates. Lower limb extremity arterial disease data (incidence, prevalence, mortality, and disability-adjusted life years [DALYs]) for China and the global aggregate were extracted from the Global Burden of Disease (GBD) study database for the period of 1990–2021. Trend analysis was performed using joinpoint regression to compute average annual percentage change (AAPC) and corresponding 95% confidence intervals (95% CIs). A comprehensive comparative analysis was performed to assess differences in burden between China and the global context, stratified by age group, sex, and temporal interval. From 1990 to 2021, trends in PAD’s age-standardized rates (ASIR, ASPR, ASMR) in China diverged from global patterns, with a slight increase in China against a worldwide decrease. Although ASDR declined in both China and globally, the global reduction outpaced that of China. The annual average percentage changes (AAPC) of the ASIR, ASPR, ASMR, and ASDR in China were 0.083%, 0.197%, 0.731%, and − 0.244%, respectively, whereas the global annual percentage changes (AAPCs) were − 0.400%, -0.430%, -1.407%, and − 1.133%, respectively. From 1990 to 2021, the ASIR, ASPR, ASMR and ASDR of PAD patients in China all tended to increase with increasing age. Globally, the ASIR of PAD patients initially increased but then stabilized with increasing age, whereas the ASPR, ASMR and ASDR all tended to increase. During the period from 1990 to 2021, the prevalence and incidence of PAD among women were higher than those among men, but the mortality rate of men was higher than that of women. Between 1990 and 2021, China recorded increases in the incidence, prevalence, and mortality of PAD, which contrasted with a decline in DALYs. Globally, all four metrics decreased. Although the burden of PAD in China has been relatively alleviated, the absolute numbers of cases, patients, and deaths increased. The disease disproportionately affected older people (peak incidence: 60–80 years), with a higher prevalence/incidence in females but elevated male mortality. China’s demographic characteristics and ageing trajectory underscore the persistent significance of PAD as a public health priority.