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Prevalence of claudication may be underestimated in women

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – New research questions prior reports of a lower prevalence of intermittent claudication in women than in men, suggesting instead that it may simply be the result of how the problem is defined based on presenting symptoms.

The main finding is that although women have the same degree of reduced blood flow to the legs and same type of arterial lesions as men, they have different presenting symptoms, lead researcher Dr. Birgitta M. Sigvant, from Central Hospital in Karlstad, Sweden, told Reuters Health.

“The clinical relevance of this study is that doctors and researcher should rely on objective criteria when diagnosing claudication, (and be aware) that women describe their symptoms differently from men. This is extremely important in order to not miss women with this disease, who should be prescribed preventive medication for cardiovascular disease.”

Dr. Sigvant presented her teamís findings Friday at the 63rd Vascular Annual Meeting in Denver.

The study included 5040 randomly selected men and women who underwent ankle-brachial index (ABI) testing and completed questionnaires regarding their medical history and symptoms of vascular disease.

The point-prevalence of intermittent claudication was 6.5% and 7.2% in women and men, respectively, and the average ABI for affected subjects was 0.7.

Nineteen percent of women with intermittent claudication had an ABI <0.5 compared with just 7% of men. Men with claudication were more likely than women to report having diabetes, stroke, and a smoking history. By contrast, hypertension was more commonly reported by women with claudication. Women with claudication had lower walking speeds than men and were more likely to report joint problems and heart palpitations. "The higher prevalence of intermittent claudication in men as known from the literature might be a consequence of sex differences in presentations of symptoms rather than a true prevalence difference," Dr. Sigvant concluded. "We suspected that this could be the case, but it was surprising to interview these women and hearing them talk about how little walking ability they (had) in contrast to the men."