Peripheral artery disease

This increasingly common disorder often goes undetected in women until serious problems arise.

Older women are learning that cardiovascular disease isn’t confined to the chest. Atherosclerosis, once known as “hardening of the arteries,” is the disease process at the root of most cardiovascular problems. It affects not only the vessels that feed the heart but also those that serve the rest of the body. When atherosclerotic plaque and blood clots reduce blood flow to the legs or less often, to the arms, the condition is called peripheral artery disease (PAD). PAD makes walking painful and slows injury healing. In the worst cases, it can be result in the loss of a toe, foot, or leg – or even death.

Like coronary artery disease (CAD), PAD was once thought to be a problem mainly for middle-aged men. One reasons is that men that age are more likely than women to complain to their doctors about leg pain. Another reason is that men with PAD are more likely than women to have CAD as well, so they come to the attention of clinicians sooner. Women with PAD tend to develop their first symptoms in their 60s and 70s – a decade later than me. By then, they may have other conditions like arthritis or peripheral neuropathy (never damage) that mask PAD symptoms and delay diagnosis. By the time a women is finally diagnosed, she’s likely to have more severe disease.

Who is at risk for PAD?

Age

About 3% of people under age 60 have PAD, and so do as 20% of those over age 70. Late in life, a higher proportion of people with PAD are women. One study with nearly 7000 participants found that at ages 85 and over, almost 40% of the women had PAD, wile less than a third of the men had condition.

Cigarette smoking

Exposure to tobacco raises the risk of atherosclerosis by constricting arteries and promoting inflammation. A 2011 report from the Women’s Health Study found that compared with nonsmokers, smokers whose lifetime exposure to cigarettes was 10 to 29 pack-years were six times more likely to develop PAD, those with a lifetime exposure of 30 or more pack-years had 11 times the risk.

Diabetes

One in the three people who are over age 50 and have diabetes will develop PAD.

Unfavorable lipid profile

Too much “bad” LDL cholesterol and too little “good” HDL cholesterol are linked to PAD. Risk increases 5% to 10% for every 10-point rise in LDL levels

Ethnicity

African American women are twice as likely as Caucasian women to develop PAD.

Heredity

Family history accounts for about 205 of a person’s overall risk.

INFOGRAPHICS

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