Women and Artery Disease
There are differences between men and women who have peripheral arterial disease (PAD). Many experts estimate that that PAD affects 20%-30% of women over the age of 70. Most experts also have concluded that PAD is often under-diagnosed and under-treated in women. Furthermore, women are underrepresented in many clinical studies to evaluate PAD treatments.
Sex Differences in PAD
Even though men and women can both have PAD, but the symptoms, risks and concerns for women are different from those of men.
Signs of PAD in Women
Women may not show signs of any disease. For this reason, women are said to have higher rates of asymptomatic or subclinical disease. This means that women are less likely to have symptoms of PAD in their legs, or they may not have severe enough symptoms for a doctor to classify as PAD.
Symptoms of PAD in Women
More often than men, women may have “atypical symptoms.” Typically, a person with PAD may have pain when they walk (called “claudication”), constant pain even when not walking or exercising (called “rest pain”) or wounds on the ankles or feet (“ischemic ulcers”). But women may not present with “typical” symptoms with PAD are more likely to have leg symptoms both at rest and while exercising, which can make PAD harder to diagnose in women. On average, women are diagnosed 10-20 later than men. Women with PAD also have higher rates of depression compared to women without PAD and men with PAD.
Non-Hispanic Black women over the age of 70 are at the highest risk for developing PAD. Black women are also at highest risk of getting an amputation. Experts have linked vascular issues related to pregnancy (e.g., preeclampsia) with a higher risk of PAD. These women are also at risk for coronary artery and cerebrovascular disease. One study found that men were more likely to receive better risk factor prevention than women, even though some risk factors (diabetes, high blood pressure, and high total cholesterol) may be more common in women.
Response to Treatment
Even though exercise may reduce pain, a few studies have shown that after 1 year of exercise therapy, improvements in walking distance were a lot lower in women than in men. Women also may have a lower quality of life and lower health status.
Where can I be evaluated and treated for PAD?
Several nonsurgical and surgical treatment options are available to treat PAD. The first step is getting a thorough evaluation and diagnosis. At NVP, we have dedicated highly specialized vascular physicians to diagnose and treat your condition in a comfortable outpatient setting.
Contact us today.
Srivaratharajah K, Abramson BL. Women and Peripheral Arterial Disease: A Review of Sex Differences in Epidemiology, Clinical Manifestations, and Outcomes. Can J Cardiol. 2018 Apr;34(4):356-361. doi: 10.1016/j.cjca.2018.01.009. Epub 2018 Jan 31. PMID: 29571419.
Mentias A, Vaughan-Sarrazin M, Saad M, Girotra S. Sex Differences in Management and Outcomes of Critical Limb Ischemia in the Medicare Population. Circ Cardiovasc Interv. 2020 Oct;13(10):e009459. doi: 10.1161/CIRCINTERVENTIONS.120.009459. Epub 2020 Oct 20. PMID: 33079598; PMCID: PMC7583656.