Outcome inequality in leg artery disease

Common treatments for peripheral artery disease may be prescribed less often and be less effective in women than in men, researchers say today.

Dr Mary Kavurma of the Heart Research Institute, Australia, and colleagues report on the outcome gap between the sexes.

They explain in European Heart Journal – Quality of Care and Clinical Outcomes, that treatments for peripheral artery disease (PAD) were largely developed in men.

The condition appears to be at least as prevalent in women as men, but women tend to have poorer outcomes. Evidence for this study came from the World Health Organization’s model for analysis of gender-related needs in health care.

Dr Kavurma said: “Greater understanding is needed about why we are failing to address the health outcome gap between genders.

“This review encompasses not just biological reasons but also how health care services and women’s part in society may play a role. All of these elements should be taken into account so that more effective methods of diagnosis and treatment can be targeted at women with PAD.”

The report covers biological, clinical and societal reasons why PAD may be overlooked in women. For example, women often have no symptoms or atypical ones such as minor pain or discomfort while walking or at rest.

Women are offered amputation surgery less often, and when they do have it they are more likely to die afterwards.

In addition, the paper points out that “The higher poverty and socioeconomic disparities experienced by women globally may contribute to increased rates of PAD in women.

Dr Kavurma calls for clinical trials to be more inclusive of women in order to improve treatments.

Kavurma, M. M. et al. A hidden problem: peripheral artery disease in women. European Heart Journal – Quality of Care and Clinical Outcomes 8 March 2023; doi: 10.1093/ehjqcco/qcad011.

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