Sex differences in the prevalence of peripheral artery disease in patients undergoing coronary catheterization

Amir H. Sadrzadeh Rafie, Marcia L. Stefanick, Stacy T. Sims, Tiffany Phan, Mamie Higgins, Andre Gabriel, Themistocles Assimes, Balasubramanian Narasimhan, Kevin T. Nead, Jonathan Myers, Jeffrey Olin, John P. Cooke

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


To determine whether there are sex differences in the prevalence of peripheral artery disease, we performed an observational study of 1014 men and 547 women, aged ≥ 40 years, referred for elective coronary angiography. Women were slightly older, more obese, had higher low-density lipoprotein cholesterol (LDL-C) levels and systolic blood pressure (BP), and were more likely to be African American. Women had higher high-density lipoprotein cholesterol (HDL-C) levels, lower diastolic BP, and were less likely to smoke or to have a history of cardiovascular disease. Women had less prevalent (62% vs 81%) and less severe coronary artery disease (CAD) (p < 0.001 for both) by coronary angiography, but more prevalent peripheral artery disease (PAD) as determined by the ankle-brachial index (ABI) than men (23.6% versus 17.2%). Independent predictors of lower ABI were female sex, black race, older age, tobacco use, CAD, diabetes, and triglyceride level. In a full multivariable logistic regression model, women had a risk-adjusted odds ratio for PAD of 1.78 (95% CI 1.25-2.54) relative to men. Among patients referred for coronary angiography, women have less prevalent and less severe CAD, but more prevalent PAD, a sex difference that is not explained by traditional cardiovascular disease risk factors or CAD severity. Clinical Trial Registration-URL: Unique identifier: NCT00380185

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalVascular Medicine
Issue number6
StatePublished - Dec 2010


  • coronary artery disease
  • gender
  • intermittent claudication
  • vascular disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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