When it comes to cardiovascular disease, the different approaches to treating women and men are fairly well documented. For example, women are more likely to be told to lose weight and exercise and men are more likely to be prescribed statins.

There has been less research on sex differences in peripheral vascular diseases (PVD) that affect arteries, veins and lymphatic systems in men's and women's bodies. A new American Heart Association statement, “Sex Differences in Peripheral Vascular Disease,” should help women, men and their doctors better understand the different ways peripheral vascular diseases show up in and affect the sexes.

“PVD is often under-recognized and understudied in women compared to men,” Esther Kim, a cardiologist and vascular medicine specialist who chaired of the writing group for the statement on sex differences in symptoms, incidence and treatment when it comes to peripheral vascular disease, told TheDoctor.

The risk factors for heart disease, such as a poor diet and being sedentary, also put people at risk for PVD.

The AHA statement summarizes the current knowledge about the sex differences seen in six different types of PVD and discusses differences in risk factors, screening, treatment and outcomes.

  • Peripheral artery disease: Peripheral artery disease (PAD) restricts blood flow to the limbs and is the most common type of PVD. It affects women and men at similar rates. Women are more likely than men, however, to be asymptomatic or experience atypical symptoms. They are also more likely to experience greater functional decline and less likely to receive treatment or participate in supervised exercise programs.

    Black women have a higher incidence of peripheral artery disease than white women and are at greater lifetime risk. Despite this, they are less likely than white women to receive evidence-based treatment.

  • Aortic disease: Women with conditions affecting the aorta, the large artery that carries oxygen-rich blood away from the heart, are often diagnosed at an older age than men, and have more severe disease. Because of the protective effects of estrogen, women have a lower risk than men of conditions such as aneurysm, a bulging of the artery wall, but are at greater risk for severe complications and mortality.

    Women undergoing minimally-invasive procedures to repair their aorta have a higher mortality risk than men and are at greater risk of stroke after surgery.

  • Peripheral aneurysms and artery disorders: The frequency and outcome of these conditions vary between between men and women. Popliteal (behind the knee) artery aneurysm is 20 times more common in men than women, for example, while the non-inflammatory vascular disease fibromuscular dysplasia is five-to-nine times more common in women.

Women are more likely than men to be asymptomatic for peripheral artery disease or experience atypical symptoms.

  • Atherosclerotic Extracranial Carotid Artery Disease: The composition of plaques in the carotid artery, the large arteries on either side of the neck, differs between and women. The effect of carotid artery disease on stroke risk are also different in women, as are treatment options and outcomes. Risk factors for stroke in women include preeclampsia (high blood pressure during pregnancy), older age at menopause and the use of estrogen therapy.

  • Atherosclerotic Renal and Mesenteric Artery Disease: Research on sex differences in diseases of the renal (kidneys) and mesenteric (gastrointestinal tract) arteries are limited. Studies have found, however, that women are three times more likely than men to have chronic reduced blood flow.

  • Vasculitis: Vasculitis is an autoimmune disease that causes inflammation in the blood vessels. Its features vary by type. Takayasu arteritis, which mostly affects the aorta and its branches, is five times more common in women than men, and mostly affects women between the ages of 15 and 30. The mortality rate for Takayasu arteritis is two times higher in women.

    Giant cell arteritis, which affects arteries in the head, neck and arms, is two-to-three times more common in women, and mostly affects people between the ages of 70 and 80.

Women should talk to their doctors about their risk for PVD, urges Kim, a professor of medicine at Wake Forest University. The risk factors for heart disease, such as a poor diet and being sedentary, she added, also put people at risk for PVD.

The American Heart Association's scientific statement is published in Circulation.