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Gender and Peripheral Arterial Disease

Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine, Houston, TX (TCC, MS-A, NJP)
Michael E. DeBakey Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Baylor College of Medicine, Houston, TX (RLB)

Correspondence: Corresponding author: Tracie Collins, MD, MPH, Department of Veterans Affairs, 2002 Holcombe Boulevard (152), Houston, TX 77030 (E-mail: tcollins{at}bcm.tmc.edu)

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 ankle-brachial 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: The prevalence of PAD, a common disease within primary care clinics, does not vary by gender. Women with PAD are at greater risk for a compromise in daily function and quality of life. Future research is needed to prevent walking impairment and improve limb functioning in patients, particularly women, with PAD.