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Prevalence and incidence of LEAD in Europe

ESC Working Groups
Diseases of the Aorta, Peripheral Vascular Disease, Stroke

Atherosclerotic diseases are the leading cause of death in Europe. Usually in particular the burden of lower extremity arterial disease (LEAD) is underestimated. According to a current review the number of LEAD patients worldwide increased between 2010 and 2015 by 22% from 202 million subjects in 2010 to 237 million in 2015 [1].

The recent cardiovascular disease statistics from the European Society of Cardiology (ESC) provides a contemporary analysis of cardiovascular diseases across 54 European member countries [2]. In 2017 in total 25.8 million people lived with LEAD. Comparing the different countries the median age-standardized prevalence of LEAD ranged from 1460 per 100,000 habitants in Norway to 2204 in Denmark. In the ESC member countries more female than men live with LEAD but median age-standardized prevalence rates were similar for men and women. In contrast to the trend worldwide there was no relevant change in LEAD prevalence between 1990 and 2017. Nevertheless in some countries such as UK, Italy and Norway the age-standardized prevalence of LEAD exceeded by 20%.

Concerning incidence there were 2.2 million newly diagnosed cases of LEAD in the 54 ESC member countries with a mean age-standardized number of 132.2 new cases per 100,000 habitants. Again, the lowest incidence was found in Norway and the highest in Denmark. Comparing incidence over the last years there was again a large range between countries with an increase of LEAD incidence of 32% between 1990 and 2017 in UK.

Differences between countries can not only be explained by cardiovascular risk factors. In Denmark for example prevalence of diabetes was higher compared to Norway and UK and the prevalence of regular daily smokers was similar in Denmark and UK. 

In conclusion there is a large range in prevalence and incidence of LEAD between different European countries. But it must be taken in account that real prevalence of the disease is probably still underestimated because a large number of LEAD patients have no clinical symptoms [3].    


  1. Song P, Rudan D, Zhu Y, et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health 2019; 7: e1020–30
  2. Timmis A, Townsend N, Gale C, et al.; European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J. 2020; 41, 12-85.
  3. Aboyans V, Ricco JB, Bartelink MEL, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Eur Heart J. 2017 Aug 26. doi: 10.1093/eurheartj/ehx095
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

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