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Objectives: The association between cardiovascular disease and depression is well-established. Peripheral arterial disease arises from atherosclerosis like other cardiovascular disease, but unlike other cardiovascular disease, it impairs ambulation and lower extremity function. Given peripheral arterial disease's unique characteristics and underrepresentation in mental health research, we aimed to: (a) assess the prevalence of depression or depressive symptoms among peripheral arterial disease patients compared to coronary artery disease rates, (b) assess whether an independent association between peripheral arterial disease and depression exists, and (c) identify associated factors that may be targeted for intervention., Design: This study was based on a systematic review., Materials and Methods: Electronic databases were searched to identify studies that examined peripheral arterial disease and depression or depressive symptoms. Methodological quality was assessed using the Newcastle-Ottawa Scale., Results: We identified 28 studies. Prevalence of depression or depressive symptoms ranged from 11-48% in 12 cross-sectional studies, and from 3-36% in 16 longitudinal studies, which is comparable to reported coronary artery disease rates. Depressed peripheral arterial disease patients were more likely to be female, African American, and have more severe peripheral arterial disease symptoms and more compromised physical function compared to non-depressed patients. There is evidence to suggest that depression exerts a negative influence on walking ability and physical function independently of peripheral arterial disease., Conclusions: There is a critical need to address depression in peripheral arterial disease patients, particularly those with characteristics that place them at increased risk. Vascular care providers appear to be the primary contact for assessing depressive symptoms, and once identified, integrated mental health providers may intervene to prevent the worsening of both depression and peripheral arterial disease.

Nutritional and body weight recommendations for cardiovascular diseases are well established, yet there are no equivalent guidelines for peripheral arterial disease (PAD). This cross-sectional study measured the prevalence of cardiovascular-related nutritional and body composition risk factors in sixty PAD patients and their association with PAD severity. A diet that exceeds daily recommended intake of fat and that falls short of recommended intakes of fiber, folate, and vitamin D was associated with increased leg pain and walking difficulty. Increased body fat and waist circumference were associated with diminished walking ability and poorer psychosocial quality of life. Future prospective investigations are merited to inform both PAD clinical care and disease management guidelines.

Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost-economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B(6) and B(12), or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease.