Peripheral arterial disease in women

Area of Science:

• Vascular Medicine
• Cardiovascular Disease
• Public Health

Background:

• Peripheral arterial disease (PAD) is a common atherosclerosis complication, increasing with age.
• Women with PAD, symptomatic or not, face elevated risks of all-cause, cardiovascular, and coronary artery disease mortality.
• Key modifiable risk factors in women include smoking, diabetes, hypertension, dyslipidemia, high homocysteine, and hypothyroidism.

Purpose of the Study:

• To review the epidemiology, risk factors, and management of PAD in women.
• To highlight the increased mortality risks associated with PAD in women.
• To outline current and future research directions for PAD in women.

Main Methods:

• Literature review of PAD epidemiology, risk factors, and treatment guidelines specific to women.
• Analysis of outcomes data regarding mortality and treatment efficacy in female PAD patients.
• Identification of research gaps, particularly concerning sex-specific mechanisms and outcomes.

Main Results:

• PAD prevalence rises with age; women often present with fewer symptoms but have significant mortality risks.
• Effective management strategies include smoking cessation, control of hypertension, diabetes, dyslipidemia, and hypothyroidism.
• Statins, anti-platelet agents (aspirin, clopidogrel), ACE inhibitors, and beta-blockers (if CAD present) are recommended. Exercise and cilostazol improve claudication symptoms. Chelation therapy is ineffective.

Conclusions:

• PAD poses a substantial mortality risk for women, underscoring the need for early detection and aggressive management of risk factors.
• Comprehensive treatment strategies, including lifestyle modifications and pharmacotherapy, are crucial for improving outcomes in women with PAD.
• Further research is needed to understand and address the higher risk of graft failure and amputation in women undergoing revascularization procedures.