The American Heart Association has released a new scientific statement highlighting significant differences between men and women in the prevalence, risk factors, symptoms, and outcomes of peripheral vascular disease (PVD). This comprehensive analysis underscores the need for more research and tailored strategies to address these disparities, particularly in improving prevention, diagnosis, and treatment for women. The statement emphasizes that while PVD affects both genders, its impact on women is often under-recognized and understudied, leading to poorer health outcomes. It calls for greater attention to sex-specific differences to enhance the quality of life and extend the lifespan of women affected by PVD.

The scientific statement delves into various types of PVD, revealing distinct patterns in how these conditions manifest in women compared to men. For instance, peripheral artery disease (PAD), which restricts blood flow to the limbs, affects men and women at similar rates overall. However, women are more likely to experience no symptoms or atypical signs of PAD, resulting in delayed diagnosis and greater functional decline. Women with PAD tend to walk slower and cover shorter distances, reflecting the functional limitations they face. Additionally, Black women have a higher lifetime risk of PAD compared to white women but are less likely to receive evidence-based treatments.

In the case of aortic diseases, women tend to be diagnosed at older ages and present with more severe conditions. Although women have a lower incidence of certain aortic conditions due to the protective effects of estrogen, they face a disproportionately higher risk of severe complications, such as aneurysm rupture and mortality. Studies show that women are three times more likely than men to experience aneurysm rupture at the same size, and 30% of ruptures occur with smaller aneurysms in women compared to only 8% in men. Furthermore, women undergoing minimally invasive procedures face higher short- and long-term mortality rates and an increased risk of stroke after surgery.

Other vascular conditions also exhibit gender disparities. Fibromuscular dysplasia, a condition affecting the arteries, is 5-9 times more common in women than in men. Similarly, vasculitis, an autoimmune disease causing inflammation in blood vessels, occurs five times more frequently in women, particularly younger women aged 15-30 years old. The mortality rate for Takayasu arteritis, a type of vasculitis, is twice as high in women, and women receiving prednisone-only treatments for giant cell arteritis face five times more treatment challenges than men.

To address these disparities, the statement outlines several key recommendations for future research and clinical practice. It calls for better representation of women in clinical trials to ensure meaningful analysis of sex-specific differences in treatment efficacy, safety, and outcomes. Data should be analyzed by sex to better understand variations in response to treatments. Moreover, there is a need to establish optimal treatment strategies for women, considering their unique physiology and disease presentation. Enhanced education for healthcare professionals, improved screening strategies, and better access to guideline-recommended therapies are also essential to improve long-term prognosis for women with PVD.

This scientific statement highlights the critical importance of addressing gender disparities in PVD. By recognizing and addressing these differences, healthcare providers can develop more effective prevention and treatment strategies that improve outcomes for women. The statement serves as a call to action for researchers, clinicians, and policymakers to prioritize sex-specific research and tailor care to meet the unique needs of women affected by PVD.