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 .
The recent cardiovascular disease statistics from the European Society of Cardiology (ESC) provides a contemporary analysis of cardiovascular diseases across 54 European member countries . 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 .