Department of Vascular Disease, University Medical Centre Ljubljana, Slovenia.
The Faculty of Medicine at the University of Ljubljana, Slovenia.
Vasa. 2024 Nov;53(6):366-370. doi: 10.1024/0301-1526/a001137. Epub 2024 Jul 17.
Peripheral arterial disease (PAD) represents one of the most frequent manifestations of atherosclerosis in men and women. In both sexes, PAD is related to classical risk factors of atherosclerosis, which are similarly distributed, but some additional factors determine differences between men and women. More frequent asymptomatic disease in women than in men and less frequent screening in women may result in a false underestimation of the prevalence of PAD in women. All these factors may cause delayed diagnosis and treatment of PAD in women. Estrogen hormones have vasoprotective properties that lower the prevalence of atherosclerosis in women of younger age. However, estrogen probably does not have a protective role against the development of cardiovascular disease in women of an older age. Hormone replacement therapy (HRT) of less than one year does not appear to reduce the odds of developing PAD in postmenopausal women. It may even increase the risk of morbidity from vascular interventions. However, some studies indicated that HRT for more than one year significantly decreases the risk of PAD if administered early after the last menstruation. Also, treatment of PAD in women differs to some extent from men.
外周动脉疾病（PAD）是男性和女性中最常见的动脉粥样硬化表现之一。在男性和女性中，PAD 都与动脉粥样硬化的经典危险因素有关，这些危险因素的分布相似，但一些额外的因素决定了男女之间的差异。女性无症状疾病比男性更常见，女性筛查较少，这可能导致对女性 PAD 患病率的错误低估。所有这些因素都可能导致女性 PAD 的诊断和治疗延迟。雌激素具有血管保护作用，可降低年轻女性患动脉粥样硬化的患病率。然而，雌激素可能对老年女性心血管疾病的发展没有保护作用。不到一年的激素替代疗法（HRT）似乎不会降低绝经后妇女发生 PAD 的几率。它甚至可能增加血管介入治疗的发病率。然而，一些研究表明，如果 HRT 在最后一次月经后早期使用，超过一年的 HRT 可显著降低 PAD 的风险。此外，女性 PAD 的治疗在某种程度上与男性不同。
