Top Things to Know: Call to Action – Women and Peripheral Artery Disease

1. PAD is a marker of systemic atherosclerosis. It is under-diagnosed, under-treated and poorly understood by many practicing clinicians.¹
2. There are approximately 8 million persons in the United States afflicted with PAD.² In women between the ages of 45 to 93, the reported prevalence ranges from 3% to 29% over five decades.³
3. The purpose of this update is to provide new strategic approaches to improving the diagnosis and treatment of women with PAD.
4. Intermittent claudication is not a classical symptom in women with PAD.
5. The best way to diagnose PAD is by a vascular history and physical exam, supported by targeted measurement of the ankle-brachial index.⁴
6. Revascularization therapy selection criteria should not be limited to gender only.
7. Women, particularly African-American women, are more likely than men to suffer from the following:
   a. graft failure or limb loss
   b. loss of independent functional capacity
   c. ischemic events and amputations
8. Cilostazol is just as effective in treating claudication in women as men.
9. Joint efforts between PAD and women’s cardiovascular programs could help improve diagnosis and treatment of women with PAD.
10. Although continued gender specific research is needed to establish good measurements of PAD, these recommendations provide an improvement upon current knowledge and will improve female patient outcomes.

References

1. Barletta G, Perna S, Sabba C, et al. Quality of life in patients with intermittent claudication: relationship with laboratory exercise performance. Vasc Med. 1996;1:3-7.
2. Roger VL, et al; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012;125:e12–e230.
3. Higgins, J.P. and J.A. Higgins, Epidemiology of peripheral arterial disease in women. J Epidemiol, 2003. 13(1): p. 1-14.
4. Aboyans, V., The measurement and interpretation of the ankle-brachial index: A Scientific Statement from the American Heart Association.