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This editorial refers to ‘Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence’, by H. Reinecke et al ., doi:10.1093/eurheartj/ehv006. Peripheral artery disease of the lower extremities (PAD) has become increasingly recognized as a major contributor to the cardiovascular public health burden. It identifies a cohort of patients at increased risk of major cardiovascular ischaemic events. Moreover, its prevalence steadily increases as the population ages, becomes more obese, and as diabetes becomes more common. The German epidemiological trial on ankle brachial index (GetABI) and the Registry REduction in Atherothrombosis for Continued Health Registry (REACH) have highlighted that even asymptomatic subjects with PAD have a prognosis almost as poor as that of patients with symptomatic disease, and demonstrated a greater degree of undertreatment of atherosclerosis risk factors relative to those with coronary artery disease or cerebrovascular disease.1,2 Follow-up data from REACH and findings from other PAD registries have revealed higher cardiovascular event rates for patients with PAD compared with patients with coronary artery disease or cerebrovascular disease, and more effective risk factor control has been shown to be associated with a lower rate of cardiovascular events.3–5 The most important recent …

Peripheral artery occlusive disease a major contributor to cardiovascular public health burden