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The incidence of peripheral arterial disease has increased in recent years owing to the aging of most populations and increased prevalence of cardiovascular risk factors such as type 2 diabetes mellitus, obesity and smoking. The ratio of resting ankle to brachial systolic pressure provides an index that has been widely used in epidemiological studies to screen for peripheral arterial disease. PAD is not common among middle aged and elderly population. Hypertension and dyslipidemia among other cardiovascular risk factors are significantly associated the risk of PAD. The risk of PAD also increases with the increase in number of cardiovascular risk factors.