Gender disparities in diagnosis and treatment of peripheral arterial disease

Treatments for peripheral arterial disease (PAD) were developed primarily in men and were less effective in women, according to a review published today in . European Heart Journal – Quality of Care and Clinical Outcomes, Journal of the European Society of Cardiology (ESC). This paper highlights the biological, clinical, and social reasons why this condition may be overlooked in women who respond poorly to treatment and have poor clinical outcomes.

We need a better understanding of why we are failing to address the gender health outcomes gap. This review includes not only biological reasons, but also how health care services and the role of women in society play a role.All these factors are taken into account, and more effective We need to be able to direct diagnosis and treatment to a woman with her PAD. ”

Mary Kavurma, Author, Associate Professor, Heart Institute, Australia

More than 200 million people worldwide suffer from PAD, and blocked arteries in the legs restrict blood flow and increase the risk of heart attacks and strokes. PAD is the leading cause of lower extremity amputations. Evidence suggests that an equal or greater number of women have the condition and have worse outcomes. This review was conducted to identify the reasons for gender inequality in PAD. Researchers have compiled the best available evidence and used the World Health Organization model to analyze gender-related needs in health care.

This document begins with an overview of gender inequalities in PAD diagnosis and treatment. We then outline the biological, clinical, and social variables responsible for these gender-related disparities. In terms of diagnosis, PAD is classified into three stages: Asymptomatic typical pain and leg cramps on walking that relieve at rest (called intermittent claudication) and, in the most severe stage, extremity-threatening chronic ischemia (CLTI) is. Includes gangrene or ulcer. Women often have no or atypical symptoms, such as mild pain or discomfort while walking or at rest. They are less likely than men to have intermittent claudication and twice as likely to present with CLTI. Hormones seem to play a role, as women tend to have typical symptoms (intermittent claudication) after menopause. Accuracy will be lower for people who do not have or have small calf muscles.

Treatment of PAD includes medication, exercise, and surgery. It is intended to help manage symptoms and reduce the risk of ulcers, amputations, heart attacks and strokes. Women are less likely than men to take recommended medications and respond less to supervised exercise regimens. Women are less likely than men to undergo surgery and are more likely to die after amputation or laparotomy.

For the reasons for the above inequalities, biological factors may contribute to gender differences in disease presentation, progression, and response to treatment. For example, women are at higher risk of blood clots (causing PAD) and have smaller blood vessels, whereas birth control pills and complications during pregnancy are associated with an increased incidence of PAD in her.

Clinical factors refer to how patients engage with health services, their relationships with their physicians, and the processes in place to diagnose and treat PAD. The paper cites the low awareness of a woman’s risk of PAD among health care professionals and the woman herself. Medical staff are less likely than men to recognize her PAD in women, and women are more likely than men to be misdiagnosed with other conditions, including musculoskeletal disorders. Women tend to minimize symptoms and are less likely to discuss her PAD with their doctor. In the past decade, only one-third of women participated in clinical trials for PAD treatment. One reason may be the inclusion criteria requiring the presence of intermittent claudication, which is less common in women.

This review identified a number of social variables that may contribute to gender inequality in PAD. People with lower socioeconomic status are more likely to have PAD and more likely to be hospitalized for PAD. Furthermore, the incidence of PAD is higher in low- and middle-income countries and rising most rapidly in women. The authors note that women have lower socioeconomic status than men in most countries. “The increasing poverty and socioeconomic disparities experienced by women around the world may have contributed to her rising PAD rates in women,” said the paper.

The authors noted the low proportion of female vascular surgeons and the low proportion of women in leadership roles and PAD guideline development teams. There is also some evidence that female patient outcomes improve when treatment is administered by female clinicians. Co-author and Associate Professor Sarah Aitken, Vascular Surgeon and Chair of Surgery, University of Sydney, commented: Also, research, publications and policies may not fully represent women’s perspectives. “

Associate Professor Kavurma urged women not to ignore symptoms. They need to stop and listen to their bodies. “

She concluded: How can a doctor diagnose and treat her PAD patient without understanding how the disease develops and whether there are gender differences? Clinical trials that are more inclusive of women are also needed. “

Since 2008, the ESC has called for recognition of gender differences in cardiovascular disease in the ESC Women’s Campaign. A number of activities continue, including a focus on women and cardiovascular disease at the ESC Congress 2011. ESC hosts the Pregnancy and Heart Disease Only Registry (ROPAC). In 2022, her ESC Gender Policy will be launched, providing targets for the inclusion of female cardiologists and cardiologists in leadership positions, and promoting initiatives to improve gender equality, including mentoring and promoting career advancement. Means were outlined.