Women are often overlooked when it comes to cardiovascular diseases (CVDs) as these issues are generally regarded to primarily affect men, but this is not the case. Peripheral arterial disease (PAD) is no exception and women are at greater risk of misdiagnosis or even delayed diagnosis. This can lead to greater morbidity and mortality.

PAD is a common yet underdiagnosed circulatory problem in which narrowed arteries reduce the blood flow to the limbs. When PAD develops, the extremities, and in particular the legs, don’t receive enough direct blood flow to keep up with demand.

More recent studies have indicated that not only is the prevalence of CVDs and PAD similar for both genders, but it is higher in women (1, 2, 3, 4). When it comes to women, studies have indicated that women are more likely to have asymptomatic PAD than their counterparts (5, 6, 7, 8, 9). Additionally, women are more likely to present with atypical symptoms that could be attributed to other medical conditions, delaying accurate diagnosis despite possible inclusion in risk groups (10).

Women are more likely to have only PAD in the absence of other CVDs (1). Compounded with the common asymptomatic presentation, this leads to a greater chance of missed diagnosis and delayed treatment. In other words, women often don’t even receive a simple screening, despite the simplicity and low cost of some diagnostic methods.

How can you screen for PAD?

There is a quick, non-invasive method to screen for PAD called an Ankle Brachial Index, or ABI. medi has a diagnostic device called the MESI ABPI which gives patients a reliable reading on extremities to help identify PAD in as little as a minute. Along with being extremely quick, the device delivers accurate results without any serious consequences, eliminates human error, and provides a clear, proper treatment plan.

Are women with PAD undertreated?

In practice, many patients, male or female, aren’t receiving proper treatment. Studies have found that patients with only PAD were less likely to receive treatment with either statins, ACE inhibitors, or antiplatelet agents than those with both PAD and CAD (11, 12). In those cases, women were even less likely than men to receive those drugs.

Women, especially older ones, are at greater risk of PAD-related morbidity and mortality due to the frequently asymptomatic nature of the disease and consequently delayed diagnosis. Possible solutions are increased screening of elderly patients, particularly those in risk groups, and aggressive treatment and risk factor modification in those with a positive diagnosis.

As September is PAD Awareness Month, it is even more important to know your risks of developing PAD and test to rule out an unknowing illness. Visit our PAD landing page to learn more and stay safe.

References:

(1) Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary Care > https://jamanetwork.com/journals/jama/fullarticle/194205

(2) A population-based study of peripheral arterial disease prevalence with special focus on critical limb ischemia and sex differences > https://www.ncbi.nlm.nih.gov/pubmed/17543683

(3) Prevalence and prediction of previously unrecognized peripheral arterial disease in patients with coronary artery disease: The peripheral arterial disease in Interventional Patients Study > https://onlinelibrary.wiley.com/doi/abs/10.1002/ccd.21969

(4) Particularities of peripheral arterial disease managed in vascular surgery in the French West Indies > https://www.ncbi.nlm.nih.gov/pubmed/18391869

(5) Prevalence and correlates of lower extremity arterial disease in elderly women > https://www.ncbi.nlm.nih.gov/pubmed/8465807

(6) Women and peripheral arterial disease: same disease, different issues > https://www.ncbi.nlm.nih.gov/pubmed/18334893

(7) Asymptomatic Peripheral Arterial Disease Is Independently Associated With Impaired Lower Extremity Functioning > https://www.ahajournals.org/doi/full/10.1161/01.cir.101.9.1007

(8) Arterial vascular disease in women > https://www.ncbi.nlm.nih.gov/pubmed/17950570

(9) Peripheral Arterial Disease in the Elderly > https://www.ahajournals.org/doi/full/10.1161/01.atv.18.2.185

(10) Sex differences in peripheral arterial disease: leg symptoms and physical functioning > https://www.ncbi.nlm.nih.gov/pubmed/12558719

(11) Risk factor profile, management, and prognosis of patients with peripheral arterial disease with or without coronary artery disease: results of the prospective German REACH registry cohort > https://www.ncbi.nlm.nih.gov/pubmed/19221687

(12) Incidence of peripheral vascular disease in women: is it different from that in men? > https://www.jtcvs.org/article/S0022-5223(03)01814-2/fulltext