Peripheral vascular disease (PVD) affects the blood vessels outside the heart and can cause serious health problems. However, it is often overlooked in women, leading to differences in diagnosis, treatment, and health outcomes.
A new scientific statement from the American Heart Association, published in Circulation, highlights these issues and calls for more research to address the gaps in care for women with PVD.
Dr. Esther S.H. Kim, a professor at Wake Forest University School of Medicine, explains that while differences in heart disease between men and women are now better recognized, similar attention has not been given to vascular diseases.
Since PVD affects blood flow to different parts of the body, it is important to understand how it impacts women differently to improve their quality of life and health outcomes.
How PVD Affects Women Differently
Several types of PVD affect men and women in different ways.
Peripheral Artery Disease (PAD): PAD restricts blood flow to the limbs and affects men and women at similar rates. However, women often experience fewer obvious symptoms, making diagnosis harder.
They also tend to have more severe limitations in walking and may not receive recommended treatments, such as supervised exercise programs. Studies show that Black women have a higher risk of PAD than white women but are less likely to receive proper care.
Aortic Disease: Conditions affecting the aorta, the body’s largest artery, tend to be diagnosed later in women. Estrogen provides some protection, so women have fewer aortic problems, but when they do occur, they are often more severe.
Women are more likely than men to suffer a rupture at the same aneurysm size. Even with treatment, women face a higher risk of complications and death, especially after minimally invasive surgeries.
Peripheral Aneurysms and Artery Disorders: Some vascular diseases, like fibromuscular dysplasia, are much more common in women, while others, like aneurysms behind the knee, are far more common in men. Understanding these differences can help doctors provide better care.
Carotid Artery Disease and Stroke Risk: Women have different risk factors for stroke, including pregnancy-related high blood pressure and menopause. Though women may develop smaller plaques in their arteries, they still face significant risks. Stroke prevention strategies need to consider these sex-based differences.
Kidney and Digestive System Blood Flow Problems: Women are more likely than men to experience chronic mesenteric ischemia (poor blood flow to the intestines). Research in this area is still limited, but studies suggest that Black adults with narrowed kidney arteries tend to have more severe high blood pressure.
Vasculitis (Blood Vessel Inflammation): Certain autoimmune diseases that cause inflammation in blood vessels, such as Takayasu arteritis and giant cell arteritis, are much more common in women. These conditions can be serious and require ongoing treatment, but women often face greater challenges in managing them.
Why These Differences Matter
Because women experience different symptoms, they are often diagnosed later than men. This delay in diagnosis can lead to worse health outcomes. Women are also less likely to receive guideline-recommended treatments and may not have equal access to therapies that could help them.
Dr. Kim emphasizes that these differences highlight the need for better awareness, more research, and improved screening and treatment options for women. Addressing these gaps could help ensure that both men and women receive the best possible care.
Next Steps for Research and Care
Experts recommend several steps to improve outcomes for women with PVD:
- More research on sex differences in PVD: Clinical trials should include enough women to study how treatments work for them. Data should also be analyzed separately for men and women to better understand differences in response to treatments.
- Better screening methods: Current guidelines do not fully account for how PVD presents in women. New strategies are needed to detect the disease earlier.
- Improved education for doctors: Health professionals should be trained to recognize differences in how PVD affects women.
- Greater access to treatments: More efforts are needed to ensure that women receive the same high-quality care as men.
Final Thoughts
This study reveals a significant issue: women with PVD often do not receive the same level of care as men. Many symptoms go unrecognized, treatments are not always offered, and outcomes can be worse.
Addressing these disparities requires more research, better screening, and equal access to treatment. By focusing on these areas, healthcare providers can improve the lives of women with PVD and help close the gender gap in vascular disease care.
If you care about heart disease, please read studies about a big cause of heart failure, and common blood test could advance heart failure treatment.
For more information about heart health, please see recent studies about a new way to repair human heart, and results showing drinking coffee may help reduce heart failure risk.
The research findings can be found in Circulation.
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