Ethnicity and peripheral arterial disease.

Introduction: the prevalence of peripheral arterial disease (PAD) is relatively well defined for the Caucasian population. Given the susceptibility of Asians and Afro-Caribbeans to coronary heart disease and stroke respectively, and the high prevalence of cardiovascular risk factors in both groups, one would expect a high prevalence of peripheral arterial disease.

Methods: a search of MEDLINE (1966-2002) was undertaken for studies on the incidence and prevalence of PAD, abdominal aortic aneurysms (AAA) and cerebrovascular disease in different ethnic groups.

Results: there are very few population-based prevalence studies assessing PAD, AAA or cerebrovascular disease in non-Caucasians. A review of hospital-based series demonstrates different patterns of PAD between ethnic groups. Blacks and Asians have a tendency towards more distal occlusive disease and AAA appear to be predominantly a disease of Caucasians. It is not clear whether these studies provide a true representation of the prevalence of arterial disease in various ethnic groups or are the result of an unmet health care need.

Conclusions: further studies are required to establish the prevalence, natural history and response to treatment of PAD, AAA and cerebrovascular disease in non-Caucasians. Only when this has been achieved, can clinically and cost-effective health care be delivered to affected individuals from different ethnic groups.