Macrovascular complications: peripheral arterial disease

Lower extremity peripheral arterial disease (PAD) is a leading cause of vascular mortality and morbidity, only surpassed by coronary artery disease (CAD) and stroke. Age and smoking are the main risk factors for developing PAD. Moreover, smoking is directly associated to the severity of PAD and it affects the prognosis of revascularization interventions. The prevalence of PAD in older people in high-income countries increases with age. CAD is a major cause of mortality in older adults and, even more relevant, is a leading cause of functional decline. Optimised medical treatment brings substantial benefits to older patients with CAD, whether treated conservatively or after revascularisation. Cerebrovascular disease poses a considerable threat, with individuals contending with diabetes exhibiting an increased risk of experiencing a spectrum of cerebrovascular complications, including stroke and cerebral small vessel disease. Ageing and hypertension are the major risk factors for stroke, together with other traditional cardiovascular factors.