Women and peripheral arterial disease: same disease, different issues.
OBJECTIVE
Atherosclerosis is a multifactorial disease and, thus, its clinical manifestations are likely to present gender-specific differences with respect to their development, course, symptom complexes and prognosis. The present study aimed to examine sex differences in peripheral arterial disease (PAD) and its clinical correlates.


METHODS
PAD severity, quality of life (assessed by ST-22), cardiovascular risk factors, inflammatory profile and comorbidity were assessed in 163 men and 68 women who were consecutively diagnosed with PAD at three Italian University vascular centres.


RESULTS
Compared to men, women showed a higher prevalence of critical limb ischemia (P = 0.018), but had a less impaired quality of life (assessed by ST-22), and were less likely to have a history of lower extremity revascularization. Furthermore, women tended to be older (P = 0.058), and more likely to present hypercholesterolemia (P = 0.053), diabetes mellitus (P = 0.001), body mass index > or = 30 kg/m2 (P = 0.003) and metabolic syndrome (P = 0.001). Conversely, C-reactive protein plasma levels were similar in the two groups. No gender-specific difference was observed in cardiovascular comorbidity; however, the condition showing the strongest association with coronary artery disease was diabetes mellitus in women (odds ratio = 4.96, P = 0.021), and smoking in men (odds ratio = 2.66, P = 0.008).


CONCLUSIONS
In PAD, there are several sex differences in baseline characteristics, especially with respect to the weight and significance of cardiovascular risk factors. Knowledge of these differences may help achieve optimal gender-specific cardiovascular risk prevention.
Brevetti
Gregorio
G
Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Italy. brevetti@unina.it
Bucur
Roxana
R
Balbarini
Alberto
A
Melillo
Elio
E
Novo
Salvatore
S
Muratori
Ida
I
Chiariello
Massimo
M
D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007249:Inflammation; D007558:Italy / Q000453:epidemiology; D007866:Leg / Q000098:blood supply*; D016015:Logistic Models; D008297:Male; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric