New research challenges the belief that older individuals are at higher risk for limb amputation due to peripheral artery disease (PAD). A study published in the American Heart Association’s journal Circulation revealed that adults in their 50s with severe PAD may face a greater risk of leg amputation compared to those in their 80s following emergency surgery to restore blood flow.
PAD affects 10-12 million adults over 40 in the United States, causing narrowed arteries that restrict blood flow to the limbs. Symptoms include painful muscle cramping in the legs during physical activity. Risk factors include smoking, diabetes, hypertension and abnormal cholesterol levels.
The study analyzed data from nearly 95,000 adults older than age 50 in England who underwent revascularization surgery between 2013 and 2020. Researchers found that patients aged 50-54 had an 18% risk of major amputation one year after emergency surgery, compared to 11.9% for those aged 80–84. At five years post-surgery, the risk increased to 28.8% for the younger group and 17% for the older group.
The risk of major amputation remained relatively low across all age groups when the surgery was elective rather than emergency. However, older patients faced a significantly higher risk of death without amputation following both elective and emergency procedures.
Qiuju Li, PhD, the study’s lead author, noted, “Our primary finding is different from the traditional belief that older people were at an increased risk of major amputation. Our study, interestingly, shows the opposite relationship.”
These findings emphasize the importance of early diagnosis and treatment of PAD. The American Heart Association’s 2024 guidelines highlight the need for coordinated care from a multispecialty team to manage the condition effectively and prevent complications.
