Abstract
Background: Women with peripheral vascular disease (PVD) remain under-diagnosed and under-treated due to lack of screening coupled with a lack of disease awareness. As the presence of PVD may be indicative of asymptomatic or subclinical cardiovascular (CV) disease, it is important to possess knowledge of risk factors and symptoms that may be associated with PVD so that appropriate medical care for systemic atherosclerosis is instituted. We screened ambulatory women for PVD and measured their knowledge and awareness of PVD and associated risk factors.
Methods: In a cross-sectional study, we screened 162 ambulatory women (40–85 years) for the prevalence of PVD and associated atherosclerotic risk factors, and administered a survey to assess the participants’ knowledge and awareness of PVD, its consequences, and their personally perceived risk of developing PVD. The electronic medical record was reviewed for documented evidence of CV risk factors, comorbidities, and corresponding treatment. Of the total cohort, 108 (66.7%) were categorized as having an increased risk of CV disease based on a modification of the Framingham CV risk score taking into account the presence of carotid intimal medial thickness (cIMT) >1.0 mm or ankle-brachial index (ABI) = 0.9 as surrogate markers for CV disease.
Results: In the subgroup of 108 at-risk women, the number of risk factors present ranged from 2 to 7. Approximately 26% had 2 documented CV risk factors (classified moderate-risk), and 74% had >2 documented CV risk factors (classified high-risk). Knowledge and awareness scores (% correct) for PVD were low regardless of CV risk factor group (<50%). To assess perceived risk, when asked whether they thought they had risk factors for PVD, 53.6% of moderate-risk women and 58.8% of high-risk women responded either ‘no’ or ‘not sure’.
Discussion: These data demonstrate that women are at an increased risk for both cardiac and non-cardiac vascular diseases, but lack knowledge and awareness of their risk and its implications for both heart and PVDs. We advocate screening programs to detect subclinical vascular and CV disease through the use of surrogate markers such as ABI and cIMT in asymptomatic women, as well as aggressive risk factor management to decrease future adverse event rates. Future longitudinal studies to evaluate the effectiveness of screening tools in the lowering of risk scores are underway.
- Received September 11, 2008.
