Sex Differences in Peripheral Artery Disease

Circ Res. 2022 Feb 18;130(4):496-511. doi: 10.1161/CIRCRESAHA.121.320702. Epub 2022 Feb 17.

Abstract

Peripheral artery disease (PAD) is a prevalent condition that confers substantial morbidity and mortality and remains underdiagnosed as well as undertreated in the overall population. Although PAD prevalence is similar or higher in women compared with men, associations of traditional and nontraditional risk factors with PAD and clinical manifestations of PAD differ by sex and may contribute to delayed or lack of diagnosis in women. Such sex-based differences in the manifestation of PAD may arise from sexual dimorphism in the vascular substrate in health as well as sex variation in the responses to vascular stressors. Despite the availability of proven therapies for improving symptoms and reducing risk of ischemic cardiovascular and limb events among patients with diagnosed PAD, important sex differences in treatment and outcomes have been observed. We provide an overview of current knowledge regarding sex differences in the epidemiology, pathophysiology, clinical presentation, and management of PAD.

Keywords: adult; cardiovascular disease; incidence; prevalence; risk factor.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Ankle Brachial Index / methods
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / physiopathology
  • Diabetes Mellitus / therapy
  • Exercise Therapy / methods
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Male
  • Peripheral Arterial Disease / diagnosis*
  • Peripheral Arterial Disease / epidemiology*
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy
  • Sex Characteristics*
  • Sex Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / physiopathology

Substances

  • Fibrinolytic Agents