Using nationwide Health Insurance Review and Assessment (HIRA) claims data (washout 2009–2010; adults aged 20–89), the annual incidence of diagnosed PAD in Korea during 2011–2018 ranged from 2.68 to 3.09 per 1,000 persons, showing an increasing trend from 2012 onward and a steep age-gradient (higher incidence with older age). Claims-based incidence reflects health-care–seeking/diagnosed PAD, not ABI-screened community PAD. [1]

In the same HIRA claims analysis, prevalence of diagnosed PAD increased steadily from 3.93 per 1,000 (2011) to 23.55 per 1,000 (2018). Because asymptomatic individuals may not present to care, claims-based prevalence can underestimate the total community burden. [1] In contrast, a community ABI-screening study reported asymptomatic PAD prevalence of 4.6% (ABI ≤0.90), illustrating the gap between “diagnosed PAD” and “screen-detected PAD.” [2]

National claims analyses reported in-hospital deaths occurring shortly after PAD diagnosis: across 2011–2018, annual counts of in-hospital deaths within 7 days ranged 24–53, and within 30 days ranged 41–89, suggesting that a substantial proportion of PAD-related in-hospital mortality clustered early after diagnosis (likely reflecting comorbidity/acute complications among those reaching hospital care). [1]

In Korean national claims data, the proportion of female PAD patients was higher than male (female roughly ~59–62% across years). Health-care utilization patterns differed by sex (women more clinic visits; men more tertiary/general hospital use). [1] Among symptomatic PAD patients undergoing endovascular therapy (EVT) in a large Korean registry analysis, women experienced higher rates of adverse outcomes (death/MI/major amputation composite) than men, underscoring sex differences in PAD severity/outcomes in treated cohorts. [3]

Both national claims analyses and ABI-based studies show PAD burden rises markedly with age. In claims data, incidence increased across age strata with the largest absolute increase seen in the oldest age groups, consistent with cumulative atherosclerotic risk. [1]

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Korean epidemiologic evidence differentiates (a) diagnosed PAD in claims data (health-care–utilizing PAD, often symptomatic or comorbidity-driven) from (b) ABI-defined PAD in community screening (often asymptomatic). [1][2] ABI ≤0.90 is commonly used to define PAD in population screening studies. [2,4] Clinically, PAD is typically described along a spectrum from asymptomatic disease to intermittent claudication and chronic limb-threatening ischemia (CLTI), and Korean registry/claims work largely captures the latter two groups when procedures/hospitalization are involved. [1,3]

Korean claims-based analyses describe PAD as presenting in clinical care with typical lower-extremity ischemic symptoms (e.g., exertional leg pain/claudication) and complications that may require hospitalization, revascularization, or amputation, while acknowledging that a meaningful share of PAD is asymptomatic and therefore under-captured by claims. [1][2]

In a Korean community ABI-screening study, older age, hypertension, and cardiovascular disease history were significant risk factors for asymptomatic PAD (ABI ≤0.90). [2]

At the population level in Korea, PAD is operationalized either by (1) claims-based diagnosis codes within the national insurance system for “diagnosed PAD,” [1] or (2) ABI measurement for community screening/clinical assessment. [2][4] A Korean population study (Namwon cohort; middle-aged/elderly) reported low ABI prevalence and its association with cardiovascular risk factors, supporting ABI’s utility as an objective marker of lower-extremity atherosclerosis in Koreans. [4]

Korean national trend analyses show a marked shift toward endovascular approaches. From 2004 to 2013, endovascular procedures increased (23→59 per 100,000) while open surgery decreased (8→6 per 100,000); balloon angioplasty increased almost threefold, and bypass using an artificial graft decreased by about 50%. [5] In 2011–2018 claims analyses, annual EVT events varied roughly 933–1422, and major/minor amputations showed a decreasing trend. [1]

Korean national claims analyses emphasize PAD as a condition associated with substantial morbidity and need for procedures, with trends showing decreasing amputations over time alongside ongoing EVT utilization. [1] In treated symptomatic cohorts, Korean registry data indicate sex-based differences in outcomes after EVT (worse composite outcomes in women), implying heterogeneity in prognosis by patient subgroup and disease severity. [3]

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[1] Incidence and Prevalence of Peripheral Arterial Disease in South Korea: Retrospective Analysis of National Claims Data. JMIR Public Health Surveillance. 2022;8(11):e34908 [2] Risk factors for asymptomatic peripheral arterial disease in Korean population: lessons from a community-based screening. Ann Surg Treat Res. 2019;97(4):210–216 [3] Sex differences in outcomes following endovascular treatment for symptomatic peripheral artery disease: an analysis from the K-VIS ELLA registry. J Am Heart Assoc. 2019;8(2):e010849 [4] Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly Koreans. J Korean Med Sci. 2005;20(3):373–378 [5] National trends for the treatment of peripheral arterial disease in Korea between 2004 and 2013. Ann Surg Treat Res. 2015;89(6):319–324