The prognostic systemic implications of lower limb atherosclerosis have previously been widely underestimated. However, the importance of peripheral arterial disease (PAD), as a major public health problem, has increasingly been acknowledged in recent years. PAD is known to be associated with a major decrease of patient quality of life and functional impairment1 and it is the leading cause of non-traumatic amputations throughout Europe and the United States. Very importantly, PAD has been shown to be rarely an isolated disease of the lower limb arteries, but rather a manifestation of generalized atherosclerotic burden: detailed patient examination often reveals a substantial overlap of (a)symptomatic atherothrombosis in the coronary, cerebral, and peripheral arteries2,3 and widespread similarities in prevalent risk factors. In contrast to the coronary arterial or cerebrovascular manifestations of the disease, PAD lends itself for simple non-invasive and reliable … *Corresponding author. Tel: +41 31 632 2111; fax: +41 31 632 4793. E-mail address : diehm{at}gmx.ch