Treatments for peripheral artery disease (PAD) were developed largely for men and are less effective in women. In addition, the disease is often overlooked in women, reports a research team in the specialist magazine “European Heart Journal”.
Women with PAD are less likely to receive recommended medications and are less likely to have surgery than men. They also respond less well to exercise therapy. The researchers cite various factors as reasons for this:
- Women often have no or atypical symptoms, such as mild pain or discomfort when walking or at rest. They are twice as likely to have serious complications.
- The ankle-brachial index, a common diagnostic method, is less accurate in people who have no symptoms or who have smaller calf muscles. For this value, the blood pressure in the upper and lower limbs is compared.
- Women tend to downplay their symptoms and are less likely to talk to their doctor about leg problems.
- Hormones seem to play a role, because after the menopause, typical symptoms such as problems with walking occur more frequently. Oral contraceptives (the “pill”) and complications during pregnancy also increase the risk of PAD.
“We need a better understanding to address the gender gap,” said Prof Mary Kavurma of the Heart Research Institute in Australia. She urged women not to ignore symptoms: “Watch out for pain in your calves when you walk or at rest. Ask your GP if you could have PAD. Women tend to go ahead and attribute sore legs to their busy lives. You need to stop and listen to your body.”
With PAD, the arteries in the legs become narrowed or blocked, restricting blood flow and increasing the risk of heart attack and stroke. A distinction is made between different stages, ranging from symptom-free to problems when walking to the most severe circulatory disorders associated with gangrene or ulcers. Since the disease forces many sufferers to take a break after walking short distances, it is colloquially known as “intermittent claudication”. Treatment includes medication, exercise, and surgery.
Which: DOI 10.1093/ehjqcco/qcad011