Sex Differences in Peripheral Arterial Disease: Leg Symptoms and Physical Functioning

McDermott, Mary M.; Greenland, Philip; Liu, Kiang; Criqui, Michael H.; Guralnik, Jack M.; Celic, Lillian; Chan, Cheeling

doi:10.1046/j.1532-5415.2003.51061.x

Cited by 141 publications

(125 citation statements)

References 43 publications

(58 reference statements)

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“…30 Similarly, in the Walking and Leg Circulation Study (WALCS) cohort of 460 PAD participants without critical limb ischemia identified from Chicago (IL)-area medical centers, the 187 women were more than twice as likely as the men to report the presence of atypical exertional leg symptoms that sometimes began at rest. 29 There were, however, no significant differences in the prevalence of asymptomatic disease between men and women with PAD in the WALCS cohort. 29 …”

Section: Clinical Presentation Of Pad In Women Leg Symptoms In Womenmentioning

confidence: 81%

“…In this regard, the presence of asymptomatic PAD and atypical exertional leg symptoms has been observed in both men and women. 2,[27][28][29][30] For example, in the Women's Health and Aging Study (WHAS) of 933 disabled women Ն65 years of age, 328 (35%) had an ABI Ͻ0.90, which established the diagnosis of PAD. 28 Of these 328 women with PAD, 63% had no exertional leg symptoms.…”

Section: Clinical Presentation Of Pad In Women Leg Symptoms In Womenmentioning

confidence: 99%

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A Call to Action: Women and Peripheral Artery Disease

Hirsch

Allison²,

Gomes³

et al. 2012

Circulation

293

138

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Section: Clinical Presentation Of Pad In Women Leg Symptoms In Womenmentioning

confidence: 81%

Section: Clinical Presentation Of Pad In Women Leg Symptoms In Womenmentioning

confidence: 99%

A Call to Action: Women and Peripheral Artery Disease

Hirsch

Allison²,

Gomes³

et al. 2012

Circulation

293

138

View full text Add to dashboard Cite

“…One prior study demonstrated that gender variation in walking impairment might be partially explained by variation in leg strength with women having poorer leg strength than men. 4 Although we did not capture leg strength within this study, women within the cohort had a higher mean BMI when compared with men. Because a BMI that is increased secondary to a higher proportion of non-lean versus lean tissue often correlates with physical inactivity, 18 this higher mean BMI in women may be a marker for poorer leg strength.…”

Section: Discussionmentioning

confidence: 99%

“…4 We have added to this body of literature by screening for disease in a racially diverse population that included Spanish-speaking patients-an often under-represented group within clinical research. Within our cohort, men and women predominantly 55 years of age and older, there was a high prevalence of atherosclerotic risk factors.…”

Section: Discussionmentioning

confidence: 99%

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Gender and Peripheral Arterial Disease

Collins¹,

Suarez‐Almazor²,

Bush³

et al. 2006

The Journal of the American Board of Family Medicine

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Objective: The aim of this study is to determine gender differences in the risk factor profile and leg symptoms of peripheral arterial disease (PAD).Methods: We identified men and women with PAD from a cohort of patients within a primary care clinic setting. We screened patients 50 years of age and older. We diagnosed PAD based on an anklebrachial index (ABI) level of less than 0.9; the ABI is the ratio of ankle and arm systolic blood pressure measurements. Patients completed 4 questionnaires, one of which was used to ascertain leg symptoms related to compromised blood flow, the San Diego Claudication Questionnaire (SDCQ). Additional questionnaires were used to determine the patient's medical history, walking impairment, and health-related quality of life.Results: We enrolled 403 patients stratified by race and gender including 55 white women, 82 African American women, and 71 Hispanic women. There were no significant differences by gender in the prevalence of disease. The prevalence of PAD was 9.1% in white women, 21.9% in African American women, and 14.1% in Hispanic women (P ‫؍‬ .11). Risk factors for PAD were the same for women and men (ie, diabetes mellitus, current smoking, and use of blood pressure medication). Walking impairment subscale scores were lower for women with PAD when compared with women without PAD and to men with disease. Scores for physical function and general health were lower for women versus men with PAD.Conclusions Case IllustrationA 63-year-old African American woman with leg discomfort comes into your practice setting complaining of cramping in legs when she walks. Retired for 8 years, she goes walking at a shopping mall with a friend 2 times per week but she must stop several times and she is unable to keep up with her friend. Her leg symptoms resolve promptly with rest, and she has no rest pain or ulcerations. Additional medical history includes hypertension for which she has been prescribed hydrochlorothiazide at 25 mg per day and ramipril at 10 mg per day. She also takes aspirin at 81 mg per day. On physical examination, she weighs 165 lbs, waist circumference is 30 inches, height is 68 inches, blood pressure sitting is 130/85 and her pulse examination reveals a normal femoral and absent popliteal and pedal pulses on the right. On the left, her pulse examination reveals a normal femoral, an absent popliteal, and absent pedal pulses. Her resting ankle-brachial index is 0.70 for the left lower extremity and 0.74 for the right lower extremity. Her lipid profile reveals a total cholesterol of 225 mg/dL, and low-density lipoprotein of 160 mg/dL, and a high-density lipoprotein of 36 mg/dL. She has a normal glucose.

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