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4.2 Risk factors

Main PAAD risk factors are summarized in Figure 3. Traditional risk factors in tools like Framingham, Reynolds, Atherosclerotic Cardiovascular Disease (ASCVD) risk estimator Plus (United States of America), SCORE2 (Systematic Coronary Risk Evaluation 2, age 40–69 years), SCORE2- Diabetes (Systematic Coronary Risk Evaluation 2 - diabetes), and SCORE2-OP (Systematic Coronary Risk Evaluation 2–Older Persons) (Europe)18 also contribute to PAAD’s pathophysiology and development. More details are available in Supplementary data online, Section 1.1, and the 2021 ESC Guidelines on CV disease prevention in clinical practice.19

Low-density lipoprotein cholesterol (LDL-C) is a pivotal factor in atherosclerosis,19 with diabetes and tobacco exposure significantly

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Traditional risk factors

Non-traditional risk factors

Female-specific

risk factors

Non-modifiable risk factors Modifiable risk factors

Overweight

Sedentary lifestyle

Sleep disorders

Apolipoproteins

Environmental pollution

Socio-economic status

Menopause

Pregnancy-induced hypertension/ diabetes

Polygenic and family inheritance

Sex Age Tobacco Diabetes Lipids

Hypertension

Stressful lifestyle

Alcohol

Diet

Inflammation Autoimmune disease

Figure 3 Main risk factors associated with atherosclerosis in peripheral arterial and aortic diseases. PAAD, peripheral arterial and aortic diseases.

ESC Guidelines                                                                                                                                                                                          3559

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