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Women with PAD lost mobility faster than men with PAD

McDermott M. J Am Coll Cardiol. 2011;57:707-714.

Issue: March 2011

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Women with lower-extremity peripheral arterial disease experienced faster functional declines than men with the condition. These functional declines included decreased endurance, lowered walking velocity and the development of mobility disabilities, according to a study.

For up to 4 years, researchers had 380 men and women with PAD undergo annual walking tests. A 6-minute walk screened for endurance mobility disability, whereas a 4-minute walk test measured declines in walking velocity. Patients who passed the tests at baseline were tracked annually. A loss of mobility was defined as losing the ability to walk for one-quarter mile or to walk up and down one flight of stairs without assistance.

At 4 years, women were more likely than men to lose the ability to walk for 6 uninterrupted minutes (HR=2.30; 95% CI, 1.30-4.06). The distance women achieved in the 6-minute walk declined faster than men (P=.041). Women were also more likely to develop a mobility disability (HR=1.79; 95% CI, 1.30-3.03), and they had quicker declines in walking velocity (P=.022). These results were adjusted for age, race, BMI, the ankle brachial index, level of physical activities and comorbidities, according to the study.

The researchers also measured the participants’ calf muscles with CT at baseline and 2- and 4-year visits. At baseline, woman had smaller calves, lower muscle density and poorer knee extension strength. When the sex differences in function decline were adjusted for calf differences, the differences in functional decline lost statistical significance.

“These findings suggest that lower calf muscle area and reduced knee extension strength in women at baseline may explain in part the faster rates of functional decline in women with PAD as compared with men with PAD,” the researchers wrote in the study. “Identifying sex differences in lower extremity outcomes among patients with PAD will help clinicians to provide prognostic information and to make optimal therapeutic decisions for patients with PAD.”

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