As the study period unfolded, they noted that women ended up walking less per week and had more difficulty walking the quarter-mile. Specifically, female PAD patients who had initially been able to complete a continuous six-minute quarter-mile walk were 2.3 times as likely as men to lose that ability by year four.
Women were also more likely to undergo a decline in unassisted mobility at a faster rate, year-to-year, than men, and were 1.9 times as likely to develop mobility disability (defined as being unable to continuously walk a quarter mile or ascend and descend a single flight of stairs without help).
Women also experienced a faster drop than men in the speed with which they could walk unassisted. And although women experienced less of an annual decline in calf muscle area and isometric knee extension strength than men, they also had generally smaller calf muscles, lower calf muscle density, and less overall knee extension strength to begin with.
The authors concluded that female PAD patients suffer faster rates of functional decline than their male counterparts.
They noted, however, that women generally started out the study with worse mobility than men, and that their faster loss of mobility might in the end be traced to the initial disadvantage women have in terms of weaker calf muscles and poorer leg strength. Viewed in reverse, the greater lower extremity "muscle reserves" typical of men may actually help protect them against the mobility ravages of PAD.
"This has not been reported before in people with PAD," McDermott noted. "So I was somewhat surprised. But there is some data in people without PAD that also shows this gender phenomenon. So it may be that because women live longer, they have more opportunity to experience these declines than men."
Regardless, McDermott stressed that the observations could have important implications for treatment protocols. Further research
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