A Call to Action: Women and Peripheral Artery Disease

• DOI: 10.1161/cir.0b013e31824c39ba
• Publication Date: 2012-02-16T08:05:55Z
• Authors: Alan T. Hirsch; Matthew A. Allison; Antoinette S. Gomes; Matthew A. Corriere; Sue Duval; Abby G. Ershow; William R. Hiatt; Richard H. Karas; Marge B. Lovell; Mary M. McDermott; Donna M. Mendes; Nancy A. Nussmeier; Diane Treat-Jacobson
• Keywords: Research Report; Peripheral Arterial Disease; 03 medical and health sciences; 0302 clinical medicine; Practice Guidelines as Topic; Humans; Women's Health; Female; American Heart Association; United States; 3. Good health

Lower extremity atherosclerotic peripheral artery disease (PAD) has a very high prevalence in most nations and in the United States.1–8 Lower extremity PAD is now known to be associated with equal morbidity and mortality and comparable (or higher) health economic costs as coronary heart disease (CHD) and ischemic stroke.9,10 Yet where surveyed, the public and clinicians (as well as health payers and government agencies) do not yet fully recognize the risks associated with PAD.11 For decades, clinicians did not recognize the impact of coronary disease in women.12 As such, women were not informed of their CHD risk. For any common disease, whether infectious, oncological, or traumatic, when more than half of the population at risk is not aware of this risk, and when this risk is not managed, preventable morbid and mortal events are inevitable. Certain health facts are now evident: Women suffer the consequences of PAD at rates at least as high as those observed in men. But major knowledge gaps exist. Clinical research to evaluate gender-based differences that might underlie the delayed, postmenopausal presentation of PAD in women has not been conducted. Whether subtle but important gender-based distinctions in clinical presentations exist is unknown. The relative sensitivity and specificity of PAD diagnostic tests and pathways by gender are unclear. Although there is suggestive evidence that treatment benefits and harms are different in women and men, this cannot yet be confirmed from current clinical trial data because of the limited inclusion of women in past investigations. Other facts provide encouragement. Women with or at risk for CHD now better understand this risk. Thus, collation of accurate PAD-specific health information for women is likely to improve their own health and that of society at large. The American Heart Association, in collaboration with …