Peripheral artery disease (PAD) occurs when blood vessels narrow, reducing blood flow to different parts of the body, primarily the legs.
A main symptom of PAD has long been claudication — pain in your legs during physical activity that stops when you’re at rest. But experts say that might not be true for everyone.
Here, Lindsey Haga, MD, Katherine Reitz, MD, and Natalie Sridharan, MD, of the UPMC Heart and Vascular Institute answer your questions about PAD.
How Can PAD Symptoms Differ Between Men and Women?
Dr. Reitz: Women may have atypical symptoms of PAD, such as abdominal pain or symptoms that mirror those of a heart attack. As a result, women may not get the diagnosis they need.
PAD is equally common in men and women. But historically, research has focused on studying men, which has led people to believe that the disease affects men more.
Dr. Sridharan: Since people think women are less likely to have PAD or other vascular diseases, they’re more likely to have their conditions dismissed or misdiagnosed. People are sometimes held to textbook presentations of what symptoms look like, but those can differ for women.
Are There Differences in When Women Should Make an Appointment?
Dr. Haga: Women often have a high tolerance for pain, so they may not seek treatment until their condition has progressed. At a consultation, they might say, “I can’t keep up with my family like I used to, but I can still walk.”
An exam may then identify an issue that we should’ve addressed months ago. Many women don’t complain about how they feel, especially if they’re busy taking care of others.
What Other Life Experiences May Impact a Woman’s Need for Vascular Care?
Dr. Haga: We now know that certain factors in a woman’s lifespan may increase their risk of heart and vascular disease. These can include:
- How old they were when they got their first period.
- Pregnancy complications, such as preeclampsia, hypertension, and gestational diabetes.
- Syndromes like polycystic ovarian syndrome.
- When they reached menopause.
These risk factors can help guide us in providing optimal medical therapy (OMT) for cardiovascular disease.
Women should discuss their health history with at least their primary care provider (PCP) and ideally, with a heart or vascular specialist, as well. It’s hard to recognize gender differences if they aren’t recognized at the most basic level in the history and physical exam.
What Does Research Show Regarding Treatment Plans for Women Compared to Men?
Dr. Reitz: My colleagues and I have studied OMT for women compared to men when it comes to vascular care. We’ve discovered that, although women are more likely to visit a PCP, their providers are less likely to prescribe OMT.
For people with a vascular disease, OMT may include statins, antiplatelet medications, or a recommendation to stop smoking. But our research found that women more frequently receive pain medicine instead.
Can You Talk About the Comprehensive Care Options Available to All Patients at UPMC?
Dr. Sridharan: We have state-of-the-art equipment and tools that allow us to provide the full breadth of treatment options. Whether that’s conservative treatments, exercise therapy, bypass surgery, balloons, stents, or some combination of those, we have it at UPMC.