The Global Epidemiological Transition in Cardiovascular Diseases: Unrecognised Impact of Endemic Infections on Peripheral Artery Disease

An epidemiological transition in the prevalence of peripheral artery disease (PAD) is taking place especially in low- and middle-income countries (LMICs) where an ageing population and adoption of western lifestyles are associated with an increase in PAD. We discuss the limited evidence which suggests that infection, potentially mediated by inflammation, may be a risk factor for PAD, and show by means of an ecological analysis that country-level prevalence of the major endemic infections of HIV, tuberculosis and malaria are associated with the prevalence of PAD. While further research is required, we propose that scientists and health authorities pay more attention to the interplay between communicable and non-communicable diseases, and we suggest that limiting the occurrence of endemic infections might have some effect on slowing the epidemiological transition in PAD.

Automated summary

An epidemiological transition is occurring in the prevalence of peripheral artery disease (PAD), particularly in low- and middle-income countries (LMICs) due to an aging population and western lifestyle adoption. Limited evidence suggests that infection, potentially mediated by inflammation, may be a risk factor for PAD. An ecological analysis also shows a correlation between country-level prevalence of major endemic infections and PAD prevalence.