Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, 789 Howard Avenue, New Haven, CT, 06519, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
Curr Cardiol Rep. 2024 Oct;26(10):1085-1095. doi: 10.1007/s11886-024-02106-6. Epub 2024 Jul 29.
Peripheral artery disease (PAD) is a growing global epidemic. Women with PAD are at elevated risk of experiencing psychosocial stressors that influence the diagnosis, management, and course of their illness due to unique sex- and gender-based factors.
We review existing evidence for increased psychosocial risk in women with PAD with a focus on mood disorders, chronic stress, pain experiences, substance use disorders, health behaviors and illness perceptions, and healthcare access. We discuss how these factors exacerbate PAD symptomatology and lead to adverse outcomes. Existing gaps in women's vascular care are reviewed and potential solutions to bridge these gaps through psychosocial care integration are proposed. Current care paradigms for women's vascular care do not adequately screen for and address psychosocial comorbidities. Clinician education, integration of evidence-based psychological care strategies, implementation of workflows for the management of individuals with PAD and mental health comorbidities, reform to reimbursement structures, and further advocacy are needed in this space. This review provides a construct for integrated behavioral health care for women with PAD and advocates for further integration of care.
外周动脉疾病（PAD）是一种日益严重的全球性疾病。由于独特的性别因素，患有 PAD 的女性面临更高的心理社会压力风险，这些压力会影响她们的疾病诊断、管理和病程。
我们回顾了 PAD 女性中增加的心理社会风险的现有证据，重点关注情绪障碍、慢性压力、疼痛体验、物质使用障碍、健康行为和疾病认知以及医疗保健获取。我们讨论了这些因素如何使 PAD 症状恶化并导致不良后果。我们还审查了女性血管护理中存在的差距，并提出了通过整合心理社会护理来弥合这些差距的潜在解决方案。目前女性血管护理的护理模式不能充分筛查和解决心理社会共病问题。在此领域需要对临床医生进行教育、整合基于证据的心理护理策略、为患有 PAD 和精神健康共病的个体实施管理工作流程、改革报销结构以及进一步倡导。本综述为 PAD 女性提供了综合行为健康护理的框架，并倡导进一步整合护理。
