Statement highlights:
- Peripheral vascular disease (PVD) – Conditions affecting the arteries, veins and lymphatic systems throughout the body have significantly different incidence, risk factors, diagnosis, treatment and outcomes between women and men.
- Women with PVD often experience subtle or atypical symptoms, leading to delayed diagnosis and diagnosis, and are less likely to receive the treatment recommended by the guidelines.
- Increased expression of women in target screening, customized treatment strategies, and clinical trials are key priorities for addressing these gaps and improving the long-term prognosis of patients with PVD.
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Dallas, March 11, 2025 – Disparities between men and women in prevalence, prevalence of peripheral vascular disease (PVD), risk factors, and symptoms have a major impact on prevention, diagnosis, treatment and outcomes in women, according to the new American Heart Association Scientific Statement, published today in the association’s flagship Peer-Reviewed Journal. circulation.
“Peripheral vascular disease is often not recognized or understood in women,” said Dr. Esther SH Kim, MD, MD, MD, FAHA, chair of the writing group for the new scientific statement. Dr. Kim is a well-known chair in cardiovascular medicine, Professor of Medicine at Wake Forest University School of Medicine and director of the Women’s Cardiovascular Health Center at Atrium Health in Charlotte, North Carolina. “While the differences in heart disease between men and women are increasingly recognized, there is a lack of focus equivalent to vascular diseases affecting the blood vessels outside the heart. More research is needed to identify and address these disparities to improve the quality of life and extend the lives of women with PVD.”
The scientific statement, “Gender Differences in Peripheral Vascular Diseases,” summarizes current knowledge of differences between men and women with PVD. It highlights disparities in risk factors, screening, treatment, and outcomes. It then outlines key research priorities to reduce these disparities and promote health equity.
Overview of disparity
This statement highlights many disparities in risk factors, symptoms, screening, treatment, and outcomes for different types of PVD.
- Peripheral arterial disease (pad): PAD, a condition that restricts blood flow to the limbs, is the most common form of PVD, affecting men and women at a similar rate overall. However, women are more likely to experience functional declines than men, without experiences of pad symptoms or atypical signs. Women with PAD tend to walk slower and cover shorter distances, highlighting the functional limitations they often face. Additionally, women with PAD may be less likely to receive treatment recommended by the guidelines or participate in a supervised exercise program. PAD is more common in black women, with a higher lifetime risk (27.6%) for PAD compared to white women (19%), but according to the association’s association, they are often less likely to receive evidence-based recommended treatment 2024 Guidelines for Management of Lower Extremity Pads.
- Aortic Disease: Women with aortic disorder (conditions affecting) Aorta) They tend to be diagnosed at older ages, and present with more serious illness than men. Women face a disproportionate risk of severe complications, such as aneurysms, due to the protective effect of estrogen hormones, but are at a disproportionately high risk of severe complications, such as aneurysm rupture and mortality. In a UK small aneurysm test, women were three times more likely to experience an aneurysm rupture with an aneurysm of the same size than men. Furthermore, 30% of aneurysm ruptures in women occurred in smaller aneurysms, compared to 8% in men. These disparities exist in treatment as well. Women undergoing minimally invasive procedures such as intrathoracic vascular aortic repair (TEVAR) have higher short-term and long-term mortality rates and an increased risk of stroke after surgery. In acute aortic syndrome (including dissection, intramural hematoma (including blood collection within the aortic wall), and permeable aortic ulcers), the in-hospital mortality rate for women is 30% compared to 21% for men. Although screening guidelines for aortic aneurysms recommend lower repair thresholds for women (5.0 cm) than for men (5.5 cm), these thresholds may not fully reflect unique risk factors for women.
- Peripheral Aneurysms and Arterial Disorders: These conditions (fibromyodysplasia and vascular ehlers-danlos syndrome (VED)) change in frequency and outcomes between men and women. For example, fibromyodysplasia is 5-9 times more common in women than in men, but aneurysms occur about 20 times more frequently in men.
- Atherosclerotic cranial carotid disease: The carotid plaque composition of the neck and brain and the impact on stroke risk vary in women, along with treatment options and outcomes. Includes gender-specific risk factors for stroke in women Preschool (Hypertension during pregnancy), age at menopause, use of estrogen therapy. Women may have smaller plaque sizes than men, but studies show that men experience intraplaque hemorrhage (hemorrhage in arterial plaques) at a higher rate, increasing the risk of stroke.
- Atherosclerotic kidney and mesenteric artery disease: Research on differences in kidney and mesenteric arteries (the blood vessels that take blood from the aorta to the gastrointestinal tract) remains limited. The study found that women were three times more likely to be affected by chronic mesenteric ischemia (decreased blood flow) than men. Research also suggests that black adults with renal artery stenosis (stenosis of the blood vessels that supply the kidneys) have a higher rate of severe or resistant hypertension.
- Vasculitis: The development of vasculitis, autoimmune diseases that cause inflammation of blood vessels, and clinical features vary widely depending on the type. Takayas arteritis occurs five times more frequently in women, and women are two to three times more likely to develop giant cell arteritis. Takayasu is more common in young women aged 15-30, but the incidence of giant cell arteritis is the highest among people aged 70-80. Furthermore, Takayas arteritis mortality is twice as high in women, and women with giant cell arteritis treated with prednisone alone are five times more likely to face treatment challenges compared to men.
“PVD leads to serious illnesses and health complications. However, disparities between women and men interfere with unbiased outcomes. Specific disparities in effective prevention, diagnosis, treatment and care highlight the importance of customized prevention and treatment strategies,” Kim said.
Knowledge gaps and future research needs
According to the statement, research that will help define the differences in PVD between men and women should be prioritized. From cellular research to clinical trials, future research should include sex in design and reporting. Here’s the suggestion:
- Ensure proper expression for women in clinical trials. Trials should enroll more women to allow meaningful analysis of gender-specific differences in treatment efficacy, safety, and outcomes. Registration should ensure a balanced expression reflecting the prevalence of female condition.
- Analyze data by gender: Research and clinical trials should include analyses to better understand gender differences depending on treatment and intervention.
- Establish the optimal treatment strategy for women: New research is needed to determine the optimal threshold for intervention in women, taking into account differences between unique physiology and disease presentation in women.
Additionally, the statement includes suggestions that may help diagnose women with PVD and improve their long-term prognosis.
- Strengthen the education of clinicians: Healthcare professionals will benefit from training to recognize and address gender-specific differences in PVD to improve outcomes.
- Improving your screening strategy: Current screening methods and guidelines are often inadequate for women and need to be refined to explain differences in gender-specific risk factors, atypical presentations, and disease progression.
- Improve women’s access to treatments recommended in the guidelines. Addressing barriers to ensuring women have access to treatments recommended by the guidelines could help improve outcomes for women.
This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association’s Council on Peripheral Vascular Diseases. Cardiovascular and Stroke Nursing Council. Clinical Cardiology Council. Genomic Precision Medicine Council. Research Council on quality and outcomes of care. And the Stroke Council. The American Heart Association’s scientific statement will help promote greater awareness about cardiovascular disease and stroke issues and promote informed health care decisions. The scientific statement outlines what is currently known about the topic and areas where additional research is needed. Scientific statements inform the development of guidelines but do not recommend treatment. The American Heart Association guidelines provide recommendations for the association’s official clinical practice.
Co-authors are Vice-Chairman Shipra Aliya, MD and SM. Yolanda Blythe, Mary; Heather L. Gornik, MD, MHS, FAHA; Chandler A. Long, MD; Mary M. McDermott, MD, FAHA; Amy Westpollack, MD, M.Sc., FAHA; Vincent Lopez Lowe, MD; Alexander E. Sullivan, MD, MSCI; Disclosures of the authors, RN, RN, PHN, are listed in the manuscript.
Associations receive funds primarily from individuals. Foundations and businesses (including drugs, device manufacturers and other companies) also make donations to fund specific association programs and events. The Association has strict policies to prevent these relationships from affecting the content of science. Revenues from pharmaceutical and biotech companies, device manufacturers, health insurance providers, and overall financial information from the association are available here.
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About the American Heart Association
The American Heart Association is a relentless force for a longer, healthier world of living. Dedicated to ensuring equitable health across all communities, the organization has been a leading source of health information for over 100 years. Supported by more than 35 million volunteers worldwide, we fund groundbreaking research, advocate for national health, and provide important resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy and care, we work tirelessly to promote health and change our lives every day. Connect with us heart.org, Facebook, x Or call 1-800-AHA-USA1.
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