Incidence of peripheral vascular disease in women: is it different from that in men?

Abstract

The gender initiative continues with editorials addressing noncardiac vascular surgery: (1) Experts discuss sex-based differences in the prevalence of vascular disease; (2) the pathophysiology, risks, and benefits of surgical treatment of carotid disease in women; (3) the need for clarifying optimal timing for surgical repair of abdominal aortic aneurysms in women and for refining endovascular repair technology for small patients; and (4) current outcomes (limb salvage, graft patency, and mortality) and future research in women with peripheral arterial occlusive disease. The series continues next month with editorials on end-stage heart failure.

Percutaneous intervention for infrainguinal occlusive disease in women: Equivalent outcomes despite increased severity of disease compared with men

“…29 Multiple studies have confirmed the finding that women are more likely to present with limb-threatening ischemia than men, a factor which generally is associated with a poorer outcome, and more likely to require amputation upon their initial presentation than men. 17,[30][31][32] Similarly, women in the current study were significantly older than men (73.2 years vs 70.3 years, P Ͻ .001) and were more likely than men to present with limb-threat (62% vs 47%, P Ͻ .0001). Additionally, women were more likely than men to have lesions of increased complexity as demonstrated by the higher proportion of TASC C and D lesions in women than in men (71.4% vs 61.7%, respectively, P Ͻ .005).…”

Effect of gender on long-term survival after abdominal aortic aneurysm repair based on results from the Medicare national database

“…34 Even when diagnosed, treatment tends to be underutilized: women with CAD are less likely to receive statins and ␤-blockers, 35,36 and those with carotid stenosis are less likely to receive antiplatelet treatment. 37 Strong emerging evidence from clinical trials (Dutch Echographic Cardiac Risk Evaluation Applying Stress Echo II and IV [DECREASE II and IV]) suggests that lack of medical optimization before procedures has a major adverse effect on perioperative cardiovascular mortality and morbidity. 38,39 The more challenging anatomy, higher chances of undiagnosed risk factors, and the higher likelihood of inadequate cardiovascular medical optimization, may partly explain why women with AAA have worse outcomes than men.…”

Lessons learned from the analysis of gender effect on risk factors and procedural outcomes of lower extremity arterial disease

“…Interestingly, in this program, women with 50% or more carotid stenosis were less likely than men to be on antiplatelet treatment (32% women vs 56% men; P ϭ .0006). 7 It is also known that women with coronary arterial disease are less frequently managed with lipid-lowering medications and beta-blockers. 30,31 Such suboptimal medical management may, in part, explain why female gender increased the risk of periprocedural mortality by 33% and 21% in patients with cerebrovascular and cardiovascular disease in our study.…”