Differences in presentation of symptoms between women and men with intermittent claudication
1 Karolinska Institutet, Stockholm, Sweden
2 Dept. of Surgery, Karlstad Hospital, Sweden
3 Medical Research Centre, Karlstad Hospital, Sweden
4 Dept. of Physiology, Karlstad Hospital, Sweden
5 Dept. of Surgery, Uppsala University Hospital, Sweden
6 The Heart Centre, Linköping University Hospital, Sweden
BMC Cardiovascular Disorders 2011, 11:39 doi:10.1186/1471-2261-11-39Published: 30 June 2011
More women than men have PAD with exception for the stage intermittent claudication (IC). The purpose of this study was to evaluate differences in disease characteristics between men and women when using current diagnostic criteria for making the diagnosis IC, defined as ABI < 0.9 and walking problems.
5040 elderly (median age 71) subjects participated in a point-prevalence study 2004. They had their ABI measured and filled out questionnaires covering medical history, current medication, PAD symptoms and walking ability. The prevalence of IC was 6.5% for women and 7.2% for men (P = 0.09). A subset of subjects with IC (N = 56) was followed up four years later with the same procedures. They also performed additional tests aiming to determine all factors influencing walking ability.
Men with IC had more concomitant cardiovascular disease and a more profound smoking history than women. Women, on the other hand, reported a lower walking speed (P < 0.01) and more joint problems (P = 0.018). In the follow up cohort ABI, walking ability and amount of atherosclerosis were similar among the sexes, but women more often reported atypical IC symptoms.
Sex differences in the description of IC symptoms may influence diagnosis even if objective features of PAD are similar. This may influence accuracy of prevalence estimates and selection to treatment.