title: Sex differences in the prevalence of peripheral artery disease in patients undergoing coronary catheterization.
abstract: To determine whether there are sex differences in the prevalence of peripheral artery disease, we performed an observational study of 1014 men and 547 women, aged ≥ 40 years, referred for elective coronary angiography. Women were slightly older, more obese, had higher low-density lipoprotein cholesterol (LDL-C) levels and systolic blood pressure (BP), and were more likely to be African American. Women had higher high-density lipoprotein cholesterol (HDL-C) levels, lower diastolic BP, and were less likely to smoke or to have a history of cardiovascular disease. Women had less prevalent (62% vs 81%) and less severe coronary artery disease (CAD) (p < 0.001 for both) by coronary angiography, but more prevalent peripheral artery disease (PAD) as determined by the ankle-brachial index (ABI) than men (23.6% versus 17.2%). Independent predictors of lower ABI were female sex, black race, older age, tobacco use, CAD, diabetes, and triglyceride level. In a full multivariable logistic regression model, women had a risk-adjusted odds ratio for PAD of 1.78 (95% CI 1.25-2.54) relative to men. Among patients referred for coronary angiography, women have less prevalent and less severe CAD, but more prevalent PAD, a sex difference that is not explained by traditional cardiovascular disease risk factors or CAD severity. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT00380185.
authors.affiliation: Stanford University Medical Center, Stanford, CA 94305-5406, USA.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Sadrzadeh Rafie
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.forename: Stacy T
authors.initials: ST
authors.lastname: Sims
authors.forename: Tiffany
authors.initials: T
authors.lastname: Phan
authors.forename: Mamie
authors.initials: M
authors.lastname: Higgins
authors.forename: Andre
authors.initials: A
authors.lastname: Gabriel
authors.forename: Themistocles
authors.initials: T
authors.lastname: Assimes
authors.forename: Balasubramanian
authors.initials: B
authors.lastname: Narasimhan
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Nead
authors.forename: Jonathan
authors.initials: J
authors.lastname: Myers
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Olin
authors.forename: John P
authors.initials: JP
authors.lastname: Cooke
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D002140:California / Q000453:epidemiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors