If blood can’t flow properly through an artery in your circulatory system, it often spells bad news for whatever is on the other side of that blockage. If it’s your heart, you could have a heart attack. If it’s your brain, you could have a stroke. Dr. Theresa Rohr-Kirchgraber explains what happens when your legs don’t get the blood flow they need, and why this may cause special problems for one half of our population.
Barbara Lewis: A new study showed that women have some serious complications from peripheral arterial disease, more so than men. What did the study find?
Dr. Rohr-Kirchgraber: This was a really interesting study and it was done in Spain. And I believe probably the basis for doing it was the understanding that women who have vascular disease, women who have problems with their arteries getting clogged up, are definitely different when it comes to heart in the presentation of that disease in women. So I think their question was: If it happens in women with arteries to the heart, so what happens with women with arteries going to the legs or claudication. Claudication is basically that feeling of a charley horse in your legs, that tiredness or heaviness in the legs. It’s a direct result of decreased blood flow going to your legs.
Lewis: So what’s the bottom line here? Is a quality of life problem? Or are there some serious complications for these women?
Dr. Rohr-Kirchgraber: I think one of the things to take into consideration is that the study was looking at are there differences between men and women when it comes to the presentation of claudication. Claudication is basically a decrease of blood flow going to the legs. It can make them feel heavy. It can make them be painful, almost like charley horses. It can certainly decrease the amount that you are able to do, because the more that you walk, the more that you move, the more pain you have, therefore the less you walk and move. So this study was trying to determine what’s the difference. The researchers knew that there was definitely a difference in the way men and women present with they have blockages in the arteries going to the heart, so I think they were trying to figure out there is also a difference in men and women when they present with pain or claudication going to their legs. It was definitely more than just quality of life. What they found was that women were typically older than men when they presented with pain and heaviness in the legs. But there were a couple of other striking differences. Women tended to be more obese. Women tended to already have more trouble with their heart. They also had more trouble with osteoarthritis or degenerative joint disease. So, because women already had higher incidences of arthritis in their hips and knees, they already have a decrease in their quality of life, and then you add onto that the pain and heaviness and frustration when you can’t walk as far as you like, then that’s a double whammy when it comes to quality of life issues.
Lewis: The lack of desire to exercise more because you have the leg cramps. So, what do you do as a physician for them? What can you do for these women?
Dr. Rohr-Kirchgraber: When women complain of leg pain that we often have to think about.. or decreased blood flow going to the legs. Because... what’s the possibility of them having decreased blood flow to the legs, and if you can improve that, then may be able to address some of the other concerns.
Dr. Theresa Rohr-Kirchgraber is a professor of medicine at the Indiana University School of Medicine. She is also the Executive Director of the IU National Center of Excellence in Women's Health.