Conventional and non-conventional risk factors for peripheral arterial disease in women

Abstract

Summary. Objectives. To conduct a scoping review of the scientific literature summarizing current knowledge regarding gender-related differences in conventional and the impact of non-conventional risk factors for peripheral arterial disease (PAD) in women. Methods. A comprehensive literature search was performed across PubMed, MEDLINE, SCOPUS and Google Scholar databases examining the risk factors for PAD. After initial identification of the most relevant articles, forward and backward citation tracking was performed for selection of additional publications. Finally, a total of 49 publications (45 original articles, 2 systematic reviews and 2 clinical practice guidelines) were included and analysed. Results. Conventional factors for the development and progression of PAD have several sex-specific features in women: more significant impact of smoking and diabetes, less effective correction of dyslipidemia and hypertension, frequent association with obesity and osteoporosis. Furthermore, current evidence highlights the importance of non-conventional risk factors for PAD in females: sex-hormones disbalance, reproductive history and adverse obstetric events. Conclusions. There are numerous gender-related peculiarities in the natural evolution of PAD in female patients which may influence the clinical presentation, diagnosis and outcomes of medical and interventional treatment. Further studies are required for a better understanding of sex-related vulnerability mechanisms and elaboration of individualized management.