title: Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease.
abstract: OBJECTIVE
  We hypothesized that women with lower extremity peripheral arterial disease (PAD) would have greater mobility loss and faster functional decline than men with PAD.
  
  
  BACKGROUND
  Whether rates of mobility loss or functional decline differ between men and women with PAD is currently unknown.
  
  
  METHODS
  Three hundred eighty men and women with PAD completed the 6-min walk, were assessed for mobility disability, and underwent measures of 4-m walking velocity at baseline and annually for up to 4 years. Computed tomography-assessed calf muscle characteristics were measured biannually. Outcomes included becoming unable to walk for 6 min continuously among participants who walked continuously for 6 min at baseline. Mobility loss was defined as becoming unable to walk for a quarter mile or to walk up and down 1 flight of stairs without assistance among those without baseline mobility disability. Results were adjusted for age, race, body mass index, physical activity, the ankle brachial index, comorbidities, and other confounders.
  
  
  RESULTS
  At 4 years of follow-up, women were more likely to become unable to walk for 6 min continuously (hazard ratio: 2.30, 95% confidence interval: 1.30 to 4.06, p = 0.004), more likely to develop mobility disability (hazard ratio: 1.79, 95% confidence interval: 1.30 to 3.03, p = 0.030), and had faster declines in walking velocity (p = 0.022) and the distance achieved in the 6-min walk (p = 0.041) compared with men. Sex differences in functional decline were attenuated after additional adjustment for baseline sex differences in calf muscle area.
  
  
  CONCLUSIONS
  Women with PAD have faster functional decline and greater mobility loss than men with PAD. These sex differences may be attributable to smaller baseline calf muscle area among women with PAD.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. mdm608@northwestern.edu
authors.forename: Mary M
authors.initials: MM
authors.lastname: McDermott
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Lu
authors.initials: L
authors.lastname: Tian
authors.forename: Melina
authors.initials: M
authors.lastname: Kibbe
authors.forename: Yihua
authors.initials: Y
authors.lastname: Liao
authors.forename: Huimin
authors.initials: H
authors.lastname: Tao
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005080:Exercise Test; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D018482:Muscle, Skeletal / Q000503:physiopathology*; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D012737:Sex Factors; D014481:United States / Q000453:epidemiology