Peripheral Arterial Disease, Smoking, and Women

Peripheral artery disease (PAD) occurs when a peripheral artery – usually in the leg -  become partially blocked by atherosclerosis; that’s why it’s often seen in people who have coronary heart disease.  It occurs in both men and women, although it’s not recognized so often in women.  The main symptom is pain in one or both legs on walking any distance, which is relieved by resting.  Harvard Medical School researchers set out to assess the presence of an association between smoking and symptoms of PAD in women.  Their findings are reported in the journal Annals of Internal Medicine.   

Almost 40,000 women healthcare professionals, who were free of cardiovascular disease, took part in the Women’s Health Study.  This started enrollment in 1993, and women who were over 45 at enrollment were followed for an average of 13 years; annual health questionnaires were completed.  Their smoking history was analyzed in relation to their first occurrence of PAD; patients were classified into 4 categories: never smoked, formerly smoked, smoked fewer than 15 cigarettes a day, and smoked 15 or more cigarettes a day.

There were 178 confirmed cases of PAD.  The rate of PAD occurrences for the 4 smoking categories were: 0.12 cases per 1,000 person years of follow-up in never-smokers, 0.34 for former smokers, 0.95 for less than 15 cigarettes a day, and 1.63 per 1,000 person-years for those smoking more than 15 cigarettes a day. Clearly, the more cigarettes a woman smokes, the more likely she is to develop to PAD. Women who stop smoking are less likely to develop PAD than those who continue. And no matter how long it has been since quitting, women who have ever smoked still have greater risk for PAD than nonsmokers.  So, don’t start to smoke, or, if you smoke now, quit!