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Home > Vascular Annual Meeting^® > SS24. The Diagnosis of Claudication Is Influenced by...

SS24. The Diagnosis of Claudication Is Influenced by Patients’ Sex

Birgitta M. Sigvant, Sr.1,2, Fredrik Lundin3, Bo Nilsson3, Eric Wahlberg4
1Central Hospital in Karlstad, Karlstad, Sweden; 2Inst of Molecular Medicine and Surgery, Karolinska University Hospital; 3Medical Research Centre Karlstad Hospital; 4Heart Centre Linköping University Hospital, Stockholm, Sweden

OBJECTIVES: PAD afflicts 18% of the elderly and the prevalence varies with PAD stage and patients’ sex. Women, for instance, dominate when diagnosis is based on ABI only, but for intermittent claudication (IC) that requires a subjective component the prevalence is higher among men. The purposes of this study was to evaluate if utilization of common diagnostic criteria for IC results in dissimilar types of IC for women and men and also to identify any possible difference in perception of IC symptoms between the sexes

METHODS: Eight thousand women and men, aged 59-89 years, were selected at random and invited to participate. The 5,040 subjects who accepted had ABI measured and completed questionnaires covering medical history, current medication, PAD symptoms and walking ability. A subset of subjects with IC at that time was followed up using the same questionnaires and also performed a walking test, underwent duplex scanning of leg arteries, ABI assessment and echocardiography. They were also interviewed in detail about their symptoms.

RESULTS: The point-prevalence of IC was 6.5% for women and 7.2% for men (p=.09) in the cohort and the mean ABI among IC subjects was 0.7 (SD 0.2). A fifth (19%) of women with IC had ABI<0.5 compared to 7% for men. Men with IC reported having DM, stroke and a smoking history more often than women, who in turn reported hypertension more frequently. Women with IC had problems with a lower (p<0.01) walking speed (p<0.01) more often than men, and a larger proportion of them experienced joint problems (p=0.018) and heart palpitations (p=0.002)

CONCLUSIONS: In this study the prevalence of IC tended to be more common among men using classic IC definitions, but this may be a consequence of sex differences in presentation of symptoms. Accordingly, IC prevalence and consequences of IC may be underestimated in women and this needs to be considered when assessing IC in epidemiological studies, clinical trials and as indication for revascularization.

AUTHOR DISCLOSURES: B.M. Sigvant, None; F. Lundin, None; B. Nilsson, None; E. Wahlberg, Grants/Research Support: Pfizer Inc, Sanofi-Aventi Inc, Consultant: Otsuka Pharma, Merck.