Challenges associated with peripheral arterial disease in women.
Challenges associated with peripheral arterial disease in women.
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DOI：
10.2147/vhrm.s45181
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发表时间：
2014
影响因子：
2.9
通讯作者：
Waisman GD
中科院分区：
文献类型：
--
作者：
Barochiner J;Aparicio LS;Waisman GD
外周动脉疾病（PAD）是一种越来越被认可的疾病，与功能障碍、生活质量恶化、心血管缺血事件风险增加以及总死亡率和心血管死亡率风险增加有关。虽然早期的研究表明，PAD在男性中更常见，但最近基于更敏感的测试的报告表明，女性PAD的患病率至少与男性相同，如果不是更高的话。女性比男性更容易出现无症状或非典型症状，并伴有合并症或女性特有的情况，如骨质疏松症、甲状腺功能减退症、口服避孕药的使用和妊娠期并发症史。女性的脂肪分布模式和不同的血管特征可能会影响诊断方法的解释，而在适当的疾病管理中，必须考虑到与性别相关的PAD患者对通常使用的药物的易感性、性别之间风险因素分布的差异以及男性和女性对血运重建手术的不同反应。所有这些问题都是与女性PAD相关的重要挑战。值得注意的是，这一群体在研究中代表性不足。因此，在诊断和管理问题方面，应承认若干与性别有关的挑战，并应弥补研究差距，以便成功地处理这一重大健康问题。
Peripheral arterial disease (PAD) is an increasingly recognized disorder that is associated with functional impairment, quality-of-life deterioration, increased risk of cardiovascular ischemic events, and increased risk of total and cardiovascular mortality. Although earlier studies suggested that PAD was more common in men, recent reports based on more sensitive tests have shown that the prevalence of PAD in women is at least the same as in men, if not higher. PAD tends to present itself asymptomatically or with atypical symptoms more frequently in women than in men, and is associated with comorbidities or situations particularly or exclusively found in the female sex, such as osteoporosis, hypothyroidism, the use of oral contraceptives, and a history of complications during pregnancy. Fat-distribution patterns and differential vascular characteristics in women may influence the interpretation of diagnostic methods, whereas sex-related vulnerability to drugs typically used in subjects with PAD, differences in risk-factor distribution among sexes, and distinct responses to revascularization procedures in men and women must be taken into account for proper disease management. All these issues pose important challenges associated with PAD in women. Of note, this group has classically been underrepresented in research studies. As a consequence, several sex-related challenges regarding diagnosis and management issues should be acknowledged, and research gaps should be addressed in order to successfully deal with this major health issue.