Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease

Mary M. McDermott, Luigi Ferrucci, Kiang Liu, Jack M. Guralnik, Lu Tian, Melina Kibbe, Yihua Liao, Huimin Tao, Michael H. Criqui

Research output: Contribution to journalArticle

Abstract

Objectives: We hypothesized that women with lower extremity peripheral arterial disease (PAD) would have greater mobility loss and faster functional decline than men with PAD. Background: Whether rates of mobility loss or functional decline differ between men and women with PAD is currently unknown. Methods: Three hundred eighty men and women with PAD completed the 6-min walk, were assessed for mobility disability, and underwent measures of 4-m walking velocity at baseline and annually for up to 4 years. Computed tomography-assessed calf muscle characteristics were measured biannually. Outcomes included becoming unable to walk for 6 min continuously among participants who walked continuously for 6 min at baseline. Mobility loss was defined as becoming unable to walk for a quarter mile or to walk up and down 1 flight of stairs without assistance among those without baseline mobility disability. Results were adjusted for age, race, body mass index, physical activity, the ankle brachial index, comorbidities, and other confounders. Results: At 4 years of follow-up, women were more likely to become unable to walk for 6 min continuously (hazard ratio: 2.30, 95% confidence interval: 1.30 to 4.06, p = 0.004), more likely to develop mobility disability (hazard ratio: 1.79, 95% confidence interval: 1.30 to 3.03, p = 0.030), and had faster declines in walking velocity (p = 0.022) and the distance achieved in the 6-min walk (p = 0.041) compared with men. Sex differences in functional decline were attenuated after additional adjustment for baseline sex differences in calf muscle area. Conclusions: Women with PAD have faster functional decline and greater mobility loss than men with PAD. These sex differences may be attributable to smaller baseline calf muscle area among women with PAD.

Original languageEnglish (US)
Pages (from-to)707-714
Number of pages8
JournalJournal of the American College of Cardiology
Volume57
Issue number6
DOIs
StatePublished - Feb 8 2011
Externally publishedYes

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Peripheral Arterial Disease
Sex Characteristics
Muscles
Walking
Confidence Intervals
Ankle Brachial Index
Comorbidity
Lower Extremity
Body Mass Index
Tomography
Exercise

Keywords

  • intermittent claudication
  • peripheral arterial disease
  • physical functioning
  • sarcopenia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease. / McDermott, Mary M.; Ferrucci, Luigi; Liu, Kiang; Guralnik, Jack M.; Tian, Lu; Kibbe, Melina; Liao, Yihua; Tao, Huimin; Criqui, Michael H.

In: Journal of the American College of Cardiology, Vol. 57, No. 6, 08.02.2011, p. 707-714.

Research output: Contribution to journalArticle

McDermott, MM, Ferrucci, L, Liu, K, Guralnik, JM, Tian, L, Kibbe, M, Liao, Y, Tao, H & Criqui, MH 2011, 'Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease', Journal of the American College of Cardiology, vol. 57, no. 6, pp. 707-714. https://doi.org/10.1016/j.jacc.2010.09.042
McDermott, Mary M. ; Ferrucci, Luigi ; Liu, Kiang ; Guralnik, Jack M. ; Tian, Lu ; Kibbe, Melina ; Liao, Yihua ; Tao, Huimin ; Criqui, Michael H. / Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease. In: Journal of the American College of Cardiology. 2011 ; Vol. 57, No. 6. pp. 707-714.
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abstract = "Objectives: We hypothesized that women with lower extremity peripheral arterial disease (PAD) would have greater mobility loss and faster functional decline than men with PAD. Background: Whether rates of mobility loss or functional decline differ between men and women with PAD is currently unknown. Methods: Three hundred eighty men and women with PAD completed the 6-min walk, were assessed for mobility disability, and underwent measures of 4-m walking velocity at baseline and annually for up to 4 years. Computed tomography-assessed calf muscle characteristics were measured biannually. Outcomes included becoming unable to walk for 6 min continuously among participants who walked continuously for 6 min at baseline. Mobility loss was defined as becoming unable to walk for a quarter mile or to walk up and down 1 flight of stairs without assistance among those without baseline mobility disability. Results were adjusted for age, race, body mass index, physical activity, the ankle brachial index, comorbidities, and other confounders. Results: At 4 years of follow-up, women were more likely to become unable to walk for 6 min continuously (hazard ratio: 2.30, 95{\%} confidence interval: 1.30 to 4.06, p = 0.004), more likely to develop mobility disability (hazard ratio: 1.79, 95{\%} confidence interval: 1.30 to 3.03, p = 0.030), and had faster declines in walking velocity (p = 0.022) and the distance achieved in the 6-min walk (p = 0.041) compared with men. Sex differences in functional decline were attenuated after additional adjustment for baseline sex differences in calf muscle area. Conclusions: Women with PAD have faster functional decline and greater mobility loss than men with PAD. These sex differences may be attributable to smaller baseline calf muscle area among women with PAD.",
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T1 - Women with peripheral arterial disease experience faster functional decline than men with peripheral arterial disease

AU - McDermott, Mary M.

AU - Ferrucci, Luigi

AU - Liu, Kiang

AU - Guralnik, Jack M.

AU - Tian, Lu

AU - Kibbe, Melina

AU - Liao, Yihua

AU - Tao, Huimin

AU - Criqui, Michael H.

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N2 - Objectives: We hypothesized that women with lower extremity peripheral arterial disease (PAD) would have greater mobility loss and faster functional decline than men with PAD. Background: Whether rates of mobility loss or functional decline differ between men and women with PAD is currently unknown. Methods: Three hundred eighty men and women with PAD completed the 6-min walk, were assessed for mobility disability, and underwent measures of 4-m walking velocity at baseline and annually for up to 4 years. Computed tomography-assessed calf muscle characteristics were measured biannually. Outcomes included becoming unable to walk for 6 min continuously among participants who walked continuously for 6 min at baseline. Mobility loss was defined as becoming unable to walk for a quarter mile or to walk up and down 1 flight of stairs without assistance among those without baseline mobility disability. Results were adjusted for age, race, body mass index, physical activity, the ankle brachial index, comorbidities, and other confounders. Results: At 4 years of follow-up, women were more likely to become unable to walk for 6 min continuously (hazard ratio: 2.30, 95% confidence interval: 1.30 to 4.06, p = 0.004), more likely to develop mobility disability (hazard ratio: 1.79, 95% confidence interval: 1.30 to 3.03, p = 0.030), and had faster declines in walking velocity (p = 0.022) and the distance achieved in the 6-min walk (p = 0.041) compared with men. Sex differences in functional decline were attenuated after additional adjustment for baseline sex differences in calf muscle area. Conclusions: Women with PAD have faster functional decline and greater mobility loss than men with PAD. These sex differences may be attributable to smaller baseline calf muscle area among women with PAD.

AB - Objectives: We hypothesized that women with lower extremity peripheral arterial disease (PAD) would have greater mobility loss and faster functional decline than men with PAD. Background: Whether rates of mobility loss or functional decline differ between men and women with PAD is currently unknown. Methods: Three hundred eighty men and women with PAD completed the 6-min walk, were assessed for mobility disability, and underwent measures of 4-m walking velocity at baseline and annually for up to 4 years. Computed tomography-assessed calf muscle characteristics were measured biannually. Outcomes included becoming unable to walk for 6 min continuously among participants who walked continuously for 6 min at baseline. Mobility loss was defined as becoming unable to walk for a quarter mile or to walk up and down 1 flight of stairs without assistance among those without baseline mobility disability. Results were adjusted for age, race, body mass index, physical activity, the ankle brachial index, comorbidities, and other confounders. Results: At 4 years of follow-up, women were more likely to become unable to walk for 6 min continuously (hazard ratio: 2.30, 95% confidence interval: 1.30 to 4.06, p = 0.004), more likely to develop mobility disability (hazard ratio: 1.79, 95% confidence interval: 1.30 to 3.03, p = 0.030), and had faster declines in walking velocity (p = 0.022) and the distance achieved in the 6-min walk (p = 0.041) compared with men. Sex differences in functional decline were attenuated after additional adjustment for baseline sex differences in calf muscle area. Conclusions: Women with PAD have faster functional decline and greater mobility loss than men with PAD. These sex differences may be attributable to smaller baseline calf muscle area among women with PAD.

KW - intermittent claudication

KW - peripheral arterial disease

KW - physical functioning

KW - sarcopenia

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