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

Paul A Agius; Julia C Cutts; Peige Song; Igor Rudan; Diana Rudan; Victor Aboyans; Mary M McDermott; Michael H Criqui; F Gerald R Fowkes; Freya J I Fowkes

doi:10.1007/s44197-022-00049-1

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

J Epidemiol Glob Health. 2022 Sep;12(3):219-223. doi: 10.1007/s44197-022-00049-1. Epub 2022 Jul 16.

Authors

Paul A Agius^{1

2

3}, Julia C Cutts^{1

4}, Peige Song^{5

6}, Igor Rudan⁵, Diana Rudan⁷, Victor Aboyans⁸, Mary M McDermott⁹, Michael H Criqui¹⁰, F Gerald R Fowkes⁵, Freya J I Fowkes^{11

12

13}

Affiliations

¹ Burnet Institute, Melbourne, VIC, Australia.
² Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
³ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
⁴ Department of Infectious Diseases, at the Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia.
⁵ Centre for Global Health, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
⁶ Department of Social Medicine, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China.
⁷ Department of Cardiology, University Hospital Dubrava, Zagreb, Croatia.
⁸ Department of Cardiology, Dupuytren University Hospital, and U1094 Inserm & IRD, Limoges, France.
⁹ Department of Medicine and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
¹⁰ Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.
¹¹ Burnet Institute, Melbourne, VIC, Australia. Freya.fowkes@burnet.edu.au.
¹² Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia. Freya.fowkes@burnet.edu.au.
¹³ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. Freya.fowkes@burnet.edu.au.

Abstract

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.

Keywords: Epidemiology; HIV; Malaria; Peripheral arterial disease; Tuberculosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / epidemiology
Humans
Noncommunicable Diseases*
Peripheral Arterial Disease* / epidemiology
Peripheral Arterial Disease* / etiology
Prevalence
Risk Factors