Heart, stroke and vascular disease: Australian facts

What is peripheral arterial disease?

Peripheral arterial disease (PAD), also known as peripheral vascular disease, is the reduced circulation of blood to a body part outside of the heart or brain. 

PAD occurs most commonly in the arteries leading to the legs and feet. It is often the result of atherosclerosis, where fatty deposits build up in the walls of arteries. In some people it does not present any symptoms, while others may experience pain at rest or while walking. In severe cases it can lead to tissue loss, and the amputation of a limb.

A notable form of PAD is abdominal aortic aneurysm. This is abnormal widening of the aorta (the main artery leading from the heart) below the level of the diaphragm. It can be a life-threatening condition if the arterial wall ruptures. Surgery is necessary in some cases. 

Tobacco smoking and diabetes are primary risk factors for PAD. Type 2 diabetes in people with PAD can accelerate atherosclerosis and increase the risk of amputation, other cardiac events such as stroke, and death.

Other PAD risk factors include abnormal blood lipids, high blood pressure, overweight or obesity, and family history of the disease. PAD has increasingly been associated with other chronic conditions such as atrial fibrillation, heart failure, obstructive sleep apnoea and chronic kidney disease.

How many Australians are living with peripheral arterial disease?

Currently, there are no national data on the number of Australians living with PAD.

PAD has been estimated to affect up to 10% of patients in primary care settings, and over 20% when studied in populations aged 75 and over (Aitken 2020, Conte & Vale 2018). Over half of all people with PAD show no symptoms, leading to under-diagnosis and under-treatment.

Hospitalisations

Peripheral arterial disease often occurs alongside other chronic diseases, so both the principal and additional diagnoses of PAD should be counted when estimating its contribution to hospitalisations.

There were around 60,200 hospitalisations where PAD was recorded as the principal and/or additional diagnosis in 2023–24, at a rate of 223 per 100,000 population. This represents 0.5% of all hospitalisations in Australia.

PAD was recorded as the principal diagnosis in 57% (34,400) of these hospitalisations.

Over half of all hospitalisations where PAD was the principal diagnosis (57%) were for atherosclerosis of the peripheral arteries, while abdominal aortic aneurysm accounted for a further 9.1%. The remainder was comprised largely of embolisms and other aneurysms.

Age and sex

Where PAD was recorded as the principal and/or additional diagnosis, hospitalisation rates:

• were overall 1.9 times as high for males as females, after adjusting for differences in the age structure of the populations. Age-specific rates were higher among males than females in all age groups, except among those aged 25–34
• increased with age and were highest among those aged 85 and over. Among this age group, rates were 1.4 and 1.7 times higher for males and females aged 75–84, respectively (Figure 1).

Trends

Between 2000–01 and 2023–24, the age-standardised rate of hospitalisations with a principal and/or additional diagnosis of PAD declined by half (50%).

During this period, the number of PAD hospitalisations declined by 6.8% for males and 13% for females, while age-standardised rates fell by 52% for males and 49% for females (Figure 2).

However, there has been a slight increase in PAD hospitalisations since 2021–22.

Variation by priority population groups

In 2023–24, age-standardised PAD hospitalisation rates:

• were 1.4 times as high for people living in the lowest socioeconomic areas compared with those in the highest socioeconomic areas
• were 1.3 times as high among people living in Remote and very remote areas as those living in Major cities.

For information on First Nations people, see First Nations people. Data disaggregated by priority population groups are available in the supplementary data tables.

Deaths

PAD was the underlying cause of 1,900 deaths in 2024, a rate of 6.9 per 100,000 population – equating to 1.0% of all deaths, and 4.4% of all cardiovascular disease deaths.

Abdominal aortic aneurysm accounted for 22% of PAD deaths with the remainder resulting from atherosclerosis of peripheral arteries, other aneurysms, embolisms and unspecified PAD.

Leading causes of death where PAD was an associated cause of death were coronary heart disease (19%), diabetes (15%) and cerebrovascular disease (6.9%).

Age and sex

In 2024, PAD death rates:

• were 1.6 times as high for males as for females, after adjusting for differences in the age structure of the populations. Age-specific rates for males were higher than for females across all age groups
• increased with age, with three-quarters (74%) of PAD deaths occurring in people aged 75 and over. PAD death rates for males and females were highest in the 85 and over age group – 3.0 times as high for males and 4.5 times as high for females aged 75–84 (Figure 3).

Trends

Between 1980 and 2024:

• the annual number of PAD deaths declined by 40%, from 3,100 to 1,900
• age-standardised PAD death rates declined by 86% for males and 87% for females. This is in parallel with broader cardiovascular disease trends and reflects improved prevention and treatment due to reduced smoking rates, widespread statin and antiplatelet use, improved control of blood pressure and diabetes, and advances in revascularisation.

Variation by priority population groups

In 2024, the age-standardised PAD death rate was:

• 1.7 times as high for people living in the lowest socioeconomic areas compared with those living in the highest socioeconomic areas. The variation by socioeconomic area was greater among males than females – 1.7 times and 1.6 times as high, respectively
• 1.2 times as high in Remote and very remote areas compared with Major cities (Figure 4).

For information on First Nations people, see First Nations people. Data disaggregated by priority population groups are available in the supplementary data tables.