Gender differences in health status and adverse outcomes among patients with peripheral arterial disease

J Am Heart Assoc. 2014 Dec 23;4(1):e000863. doi: 10.1161/JAHA.114.000863.

Abstract

Background: Few studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease (PAD). This study assessed (1) self-reported health status at PAD diagnosis and 12-months later, and explored (2) whether outcomes in women with PAD differ with regard to long-term major adverse events.

Methods and results: A total of 816 patients (285 women) with PAD were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form-12 (SF-12, Physical Component Score [PCS] and Mental Component Score [MCS]) upon PAD diagnosis and 12-months later. Women had similar ages and clinical characteristics, but poorer socio-economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical (PCS: 37±10 versus 40±10, P=0.004) and mental (

Mcs: 47±12 versus 49±11, P=0.005) health status at the time of presentation. At 12-months, women still reported a poorer overall PCS score (41±12 versus 46±11, P=0.006) and MCS score (42±14 versus 49±12, P=0.002). Female gender was an independent determinant of a poorer baseline and 12-month PCS and MCS scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [HR]=0.93, 95% CI 0.60;1.44, P=0.74) or major adverse events (unadjusted HR=0.90, 95% CI 0.63;1.29, P=0.57), after a median follow-up of 3.2 years.

Conclusions: Women's physical and mental health status is compromised both at initial PAD diagnosis and at 12-month follow-up, despite experiencing a similar magnitude of change in their health scores throughout the first 12-months after diagnosis.

Keywords: gender differences; health status; outcomes research; peripheral artery disease; women.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care Facilities
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Health Status Indicators
  • Health Status*
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Multivariate Analysis
  • Netherlands
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / mortality*
  • Peripheral Arterial Disease / therapy
  • Physical Fitness / physiology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Survival Analysis
  • Time Factors