Women and peripheral arterial disease: same disease, different issues

J Cardiovasc Med (Hagerstown). 2008 Apr;9(4):382-8. doi: 10.2459/JCM.0b013e3282f03b90.

Abstract

Objectives: Atherosclerosis is a multifactorial disease and, thus, its clinical manifestations are likely to present gender-specific differences with respect to their development, course, symptom complexes and prognosis. The present study aimed to examine sex differences in peripheral arterial disease (PAD) and its clinical correlates.

Methods: PAD severity, quality of life (assessed by ST-22), cardiovascular risk factors, inflammatory profile and comorbidity were assessed in 163 men and 68 women who were consecutively diagnosed with PAD at three Italian University vascular centres.

Results: Compared to men, women showed a higher prevalence of critical limb ischemia (P = 0.018), but had a less impaired quality of life (assessed by ST-22), and were less likely to have a history of lower extremity revascularization. Furthermore, women tended to be older (P = 0.058), and more likely to present hypercholesterolemia (P = 0.053), diabetes mellitus (P = 0.001), body mass index > or = 30 kg/m2 (P = 0.003) and metabolic syndrome (P = 0.001). Conversely, C-reactive protein plasma levels were similar in the two groups. No gender-specific difference was observed in cardiovascular comorbidity; however, the condition showing the strongest association with coronary artery disease was diabetes mellitus in women (odds ratio = 4.96, P = 0.021), and smoking in men (odds ratio = 2.66, P = 0.008).

Conclusion: In PAD, there are several sex differences in baseline characteristics, especially with respect to the weight and significance of cardiovascular risk factors. Knowledge of these differences may help achieve optimal gender-specific cardiovascular risk prevention.

MeSH terms

  • Atherosclerosis / diagnosis
  • Atherosclerosis / epidemiology*
  • Chi-Square Distribution
  • Comorbidity
  • Female
  • Humans
  • Inflammation
  • Italy / epidemiology
  • Leg / blood supply*
  • Logistic Models
  • Male
  • Peripheral Vascular Diseases / diagnosis
  • Peripheral Vascular Diseases / epidemiology*
  • Prevalence
  • Quality of Life
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Statistics, Nonparametric