Underdiagnosed Peripheral Artery Disease Poses Significant Heart Risk, Especially for Women
A simple ankle test can help detect peripheral artery disease (PAD), a condition that narrows arteries and increases the risk of heart attack and stroke.
Peripheral artery disease (PAD), a condition characterized by plaque buildup that narrows arteries, poses a significant, often overlooked, risk for heart attack and stroke, particularly among women. While commonly associated with leg pain, PAD can manifest with atypical symptoms in women, leading to delayed diagnoses and increased cardiovascular events.
PAD occurs when plaque accumulates in the arteries of the legs, pelvic area, and arms, restricting blood flow. This can result in symptoms such as leg pain during activity, changes in skin color or temperature, and slow-healing ulcers. Although PAD affects men and women equally, studies indicate that women are less likely to receive a timely diagnosis. This disparity is partly attributed to women reporting more varied and less classic symptoms compared to men.
< ]]>The consequences of untreated PAD extend beyond localized leg issues, including gangrene and, in rare cases, amputation. More critically, PAD significantly elevates the risk of major cardiovascular events. Research links PAD to a sixfold increase in the risk of heart attack and a two to threefold increase in the risk of stroke. The longer PAD remains untreated, the higher the likelihood of these severe outcomes.
Several factors contribute to the underdiagnosis in women. A study on aging women found that a substantial percentage (63%) of PAD participants did not report the classic leg pain associated with the condition. Furthermore, women with PAD are less likely to experience leg pain during walking, though they may still face considerable limitations in mobility, walking speed, and endurance. PAD also tends to emerge later in women, typically in their 60s, a decade after symptoms often appear in men.
< ]]>Biological factors, such as reduced estrogen levels in older women, may contribute to the development of arterial conditions. Additionally, symptoms of PAD can be mistaken for other age-related conditions like arthritis or osteoporosis, further complicating diagnosis.
A simple diagnostic tool, the ankle-brachial index (ABI) test, can help identify PAD. This test compares blood pressure readings taken at the ankle to those taken at the arm. A lower ankle blood pressure reading compared to the arm measurement indicates reduced blood flow to the legs, potentially signaling PAD. Individuals experiencing leg pain, numbness, discomfort, or a decrease in mobility should consider checking their ankle pulse and discussing the ABI test with their doctor.
Risk factors for PAD are largely consistent with those for general cardiovascular disease and include smoking, diabetes, advanced age, high cholesterol, obesity, an unhealthy diet, and high blood pressure. Treatment strategies include lifestyle modifications like smoking cessation and dietary changes, as well as medications such as statins. In severe cases, surgical interventions, including angioplasty, stenting, or bypass surgery, may be necessary to restore blood flow.