American women at increased risk of silent coronaries

Nov 5 2007

After examining data from government health surveys undertaken in the United States, researchers say more American women are developing a type of artery disease that raises the risk of death from heart disease and stroke.

Peripheral artery disease (PAD) is a circulatory condition in which narrowed arteries lessen the blood flow to the limbs.

PAD occurs when fatty deposits accumulate in the inner linings of artery walls, cutting blood flow and oxygen to the legs, feet, arms and other parts of the body and it raises the risk of developing and dying from heart disease and stroke.

The researchers tracked PAD, in 5,376 survey participants age 40 and older with no previous history of cardiovascular disease and found the rates among women rose from 4.1 percent in a nationally representative 1999-2000 survey to 6.3 percent in a 2003-2004 survey.

The researchers say among men, the rates fell from 3.3 percent to 2.8 percent over the same period.

The researchers say the increase was linked to an increase in obesity and they believe a large number of people are at risk but do not know it.

PAD is associated with smoking, diabetes, high cholesterol, hypertension and various inflammatory conditions and is most common among those age 70 and older.

Dr. Andrew Sumner, medical director of the Heart Station and Cardiac Prevention at Lehigh Valley Hospital in Allentown, Pennsylvania, who led the study, says PAD is a silent coronary and can be a signal of widespread accumulation of fatty deposits in the arteries, called atherosclerosis; that also may be limiting blood flow to the heart and brain.

The researchers say the same processes that contribute to the development of atherosclerosis in the legs or other limbs also contribute to the development of atherosclerosis in the arteries in the heart and neck that go to the brain.

The researchers identified PAD in these people by examining the ratio of the blood pressure in the arms and legs, known as the ankle-brachial index, in order to establish if it fit the definition for PAD.

The researchers suggest doctors should be looking for PAD in people with no overt symptoms, and say PAD rates can be expected to continue to increase as the American population ages.

The findings were presented at an American Heart Association meeting in Orlando.