title: Sex differences in peripheral arterial disease: leg symptoms and physical functioning.
abstract: OBJECTIVE
  To compare lower extremity functioning and leg symptoms between women and men with peripheral arterial disease (PAD).
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Three Chicago-area medical centers.
  
  
  METHODS
  One hundred eighty-seven women and 273 men with PAD identified consecutively in patients in the noninvasive vascular laboratories and a general medicine practice at the three medical centers.
  
  
  METHODS
  Walking speed, 6-minute walk, accelerometer-measured 7-day physical activity, and a summary performance score. The summary performance score combines data on walking velocity, time for five repeated chair rises, and standing balance to achieve a score on a 0 to 12 scale (12 = best).
  
  
  RESULTS
  Women with PAD were older and had a lower prevalence of prior leg revascularization, a higher prevalence of spinal stenosis, and a lower prevalence of other cardiovascular disease than men with PAD. Mean ankle brachial index (ABI) values +/- standard deviation were similar in women and men with PAD (0.64 +/- 0.15 vs 0.66 +/- 0.14, P =.15). Women with PAD were significantly more likely than men with PAD to have exertional leg pain that sometimes begins at rest (27.8% vs 13.2%, P <.001). Women with PAD had slower walking speed (0.81 vs 0.92 m/s, P <.001), shorter 6-minute walk distance (1,047 vs 1,182 feet, P <.001), and a poorer summary performance score (8.9 vs 9.8, P <.001) than men with PAD, adjusting for age, race, height, comorbid disease, and leg symptoms. After adjusting for leg strength, sex differences in 6-minute walk performance and summary performance score were attenuated modestly (1,089 vs 1,177 feet for 6-minute walk, P =.022 and 9.2 vs 9.8 for summary performance score, P =.027).
  
  
  CONCLUSIONS
  Women with PAD had a higher prevalence of leg pain on exertion and rest, poorer functioning, and greater walking impairment from leg symptoms than men with PAD. A higher prevalence of spinal stenosis in women may explain the observed sex differences in leg symptoms. Poorer leg strength in women may contribute to poorer lower extremity functioning in women with PAD than in men with PAD.
authors.affiliation: Department of Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA. mdm608@north-western.edu
authors.forename: Mary McGrae
authors.initials: MM
authors.lastname: McDermott
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Lillian
authors.initials: L
authors.lastname: Celic
authors.forename: Cheeling
authors.initials: C
authors.lastname: Chan
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D012727:Sex Characteristics