PAD rates will surge to 21M, costing U.S. billions

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The number of people affected by peripheral artery disease (PAD) will surge from the current 18 million to 21 million in the U.S. by 2020, with a particular increase in the rates of critical limb ischemia (CLI), according to a Sept. 30 report conducted by the SAGE group. Treating the diseases will leave the U.S. with a hefty economic burden.

Currently, CLI, a severe and often deadly form of PAD, afflicts 2.8 to 3.5 million PAD patients. According to SAGE, these rates are estimated to increase to rates of between 3.6 million and 4.5 million by 2020.

“The social consequences and the economic costs of these PAD numbers are staggering,” Mary L. Yost, SAGE president said. During the study, using the Reduction of Atherothrombosis for Continued Health (REACH) registry, the researchers estimated that the economic cost of PAD in 2004 was $102 billion, more than the cost of treating coronary artery disease alone.

According to SAGE, age and diabetes prevalence are two significant risk factors for PAD. In fact, 30 to 40 percent of diabetics aged 50 and older are diagnosed with PAD and 60 percent or more of the total number of CLI patients are diabetics. Additionally, the study showed that 60 to 80 percent of CLI occurs in patients aged 65 and older.

“Our estimates are dynamic, changing with the aging population projected by the U.S. Census Bureau and are based on the most recently reported prevalence of diabetes,” Yost said. “We calculate PAD and CLI numbers based on ‘the diabetes method,’ which begins with segmenting the population by age and glucose status then calculates the prevalence of PAD and CLI in each segment.”

A 2005-2006 National Health and Nutrition Examination Survey reported that 31 percent of the populations who are 65 or older were diagnosed with diabetes.

“PAD is expensive to treat because it is generally not diagnosed or not treated until the most severe stages (rest pain, ulcers and gangrene),” Yost concluded. “Then patients require hospitalization for costly revascularization procedures and amputations. In addition, people with PAD suffer disproportionately from other cardiovascular diseases requiring hospitalization for heart attack, stroke and other vascular conditions.”