Peripheral vascular disease, often called PVD, is a group of conditions that affect blood vessels outside the heart and brain.
These diseases can reduce blood flow to different parts of the body, including the arms, legs, kidneys, intestines, and neck. When blood cannot flow properly, organs and tissues do not receive enough oxygen and nutrients, increasing the risk of pain, disability, stroke, heart attack, and even death.
Although peripheral vascular disease affects millions of people around the world, experts say it is often overlooked in women.
A new scientific statement from the American Heart Association explains that women are less likely to be diagnosed early, may receive different treatments than men, and often have poorer health outcomes. The report was published in the journal Circulation.
The statement was led by Dr. Esther S. H. Kim, a professor at Wake Forest University School of Medicine. According to Dr. Kim, doctors now recognize that heart disease can affect women differently from men.
However, much less attention has been given to diseases that affect blood vessels throughout the rest of the body. Understanding these differences is important because earlier diagnosis and better treatment could improve the health and quality of life of many women.
One of the best-known forms of PVD is peripheral artery disease, or PAD. This condition happens when fatty deposits build up inside arteries and reduce blood flow to the legs or arms. PAD affects men and women at similar rates, but women often have fewer obvious symptoms.
Instead of experiencing the classic leg pain while walking, many women have vague symptoms or no symptoms at all. This makes the disease more difficult to recognize. Even after diagnosis, women are less likely to be referred to supervised exercise programs, which are one of the recommended treatments for improving walking ability and reducing symptoms.
The report also highlights important racial differences. Black women have a higher risk of developing PAD than white women, yet they are less likely to receive recommended medical care. This suggests that both sex and race can influence health outcomes.
Another important condition involves the aorta, the body’s largest artery. Diseases of the aorta include aneurysms, which are weak, bulging areas in the artery wall that can suddenly rupture. Women generally develop aortic disease later in life because the hormone estrogen appears to provide some protection before menopause.
However, when women do develop these conditions, they often experience more serious complications. Research shows that women have a higher risk of aneurysm rupture even when the aneurysm is the same size as one found in a man. Women also have a greater risk of complications and death after surgery, including minimally invasive procedures.
Some vascular diseases show the opposite pattern. Fibromuscular dysplasia, a condition that causes abnormal growth in artery walls, occurs much more often in women. In contrast, aneurysms that form behind the knee are much more common in men. Recognizing these differences may help doctors diagnose patients more accurately.
The report also discusses carotid artery disease, which affects the arteries supplying blood to the brain and increases the risk of stroke. Women have unique risk factors, including high blood pressure during pregnancy and hormonal changes after menopause.
Even though women often develop smaller fatty plaques in these arteries, they can still face a significant risk of stroke. This suggests that current screening and prevention strategies may need to better reflect the specific risks faced by women.
Other forms of peripheral vascular disease also affect women differently. Women are more likely to develop chronic mesenteric ischemia, a condition in which poor blood flow reduces oxygen delivery to the intestines.
Certain inflammatory diseases that attack blood vessels, including Takayasu arteritis and giant cell arteritis, are also much more common in women. These illnesses often require long-term treatment and careful medical monitoring.
One major reason these differences matter is that women are frequently diagnosed later than men. Delayed diagnosis means the disease may already be more advanced when treatment begins. In addition, women are less likely to receive guideline-recommended therapies, reducing their chances of achieving the best possible outcomes.
The American Heart Association says more research is urgently needed. Future clinical trials should include enough women to allow scientists to study how treatments work specifically for them. Researchers should also analyze results separately for women and men so important differences are not overlooked.
Doctors need better education about how peripheral vascular disease appears in women, and healthcare systems should work to ensure women have equal access to proven treatments.
This scientific statement does not introduce a new treatment, but it highlights an important problem that has received too little attention. By improving awareness, expanding research, and ensuring equal access to care, doctors may be able to diagnose peripheral vascular disease earlier and improve outcomes for millions of women worldwide.
If you care about heart health, please read studies about top 10 foods for a healthy heart, and how to eat right for heart rhythm disorders.
For more health information, please see recent studies about how to eat your way to cleaner arteries, and salt and heart health: does less really mean more?
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