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ABSTRACT
Background: Previous studies have demonstrated higher rates of peripheral arterial disease (PAD) in blacks and lower in Asians compared to whites. The aim of this study is to undertake a comprehensive review of literature on ethnic differences in the epidemiology of PAD.
Methods: A systemic review and meta-analysis included studies reporting PAD prevalence in general or diabetic populations, and comparing PAD prevalence in ethnic groups.
Results: Mean prevalence of PAD in general population for whites, blacks and Asians was 3.5%, 6.7% and 3.7% respectively. Meta-analysis demonstrated higher prevalence of PAD in blacks (p < 0.001) and lower amongst Asians (p < 0.001), compared to whites. In diabetic population, the mean prevalence of PAD for whites, blacks, east Asians and south Asians was 17%, 25.3%, 13.5% and 7.6% respectively. In diabetic population, south Asians had a lower PAD prevalence (p < 0.001) compared to whites; there was no significant difference between blacks and whites. Overall females have higher PAD rates, in general (3.8% vs 3.2%; p < 0.001) and in diabetic population (13.7% vs 10%; p < 0.001).
Conclusion: Blacks are vulnerable to PAD, in contrast to Asians who have lower prevalence of PAD when compared to whites. Further research is needed in order to identify the factors that generate this difference.
Declaration of interest
GYH Lip has worked as a consultant for Bayer/Janssen, BMS/Pfizer, Biotronik, Medtronic, Boehringer Ingelheim, Microlife and Daiichi-Sankyo; and been a speaker for Bayer, BMS/Pfizer, Medtronic, Boehringer Ingelheim, Microlife, Roche and Daiichi-Sankyo. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.