Differences in presentation of symptoms between women and men with intermittent claudication

Cohort study5040 elderly (median age 71) subjects participated in a point-prevalence study 2004. They had their ABI measured and filled out questionnaires covering medical history, current medication, PAD symptoms and walking ability. The prevalence of IC was 6.5% for women and 7.2% for men (P = 0.09). A subset of subjects with IC (N = 56) was followed up four years later with the same procedures. They also performed additional tests aiming to determine all factors influencing walking ability.Men with IC had more concomitant cardiovascular disease and a more profound smoking history than women. Women, on the other hand, reported a lower walking speed (P < 0.01) and more joint problems (P = 0.018). In the follow up cohort ABI, walking ability and amount of atherosclerosis were similar among the sexes, but women more often reported atypical IC symptoms.Sex differences in the description of IC symptoms may influence diagnosis even if objective features of PAD are similar. This may influence accuracy of prevalence estimates and selection to treatment.Peripheral arterial disease (PAD) is common in western countries, affecting almost 20% of elderly populations and its prevalence differs between sexes. Findings of the Swedish PAD Prevalence Study (SPPS) revealed that women are more likely to suffer from PAD when diagnosis is based only on ankle brachial indices (ABI) but when diagnosis relies on additional assessment of symptoms (ie IC) sex differences disappears [1,2].The prevalence of IC is around 7% among elderly [1], and considerably diminishes patients' quality of life (QoL) [3,4] The extent of this influence on QoL determines whether surgical intervention is indicated. Accordingly, a correct diagnosis, accurate assessment of disease severity and weighing the risk associated with the procedure against the magnitude of potential symptomatic improvement is essential for recommending the best treatment option. A correct diagnosis is also essential to enable appropriate m