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.