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Smoking and Peripheral Artery Disease in Women FREE

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The full report is titled “Smoking, Smoking Cessation, and Risk for Symptomatic Peripheral Artery Disease in Women. A Cohort Study.” It is in the 7 June 2011 issue of Annals of Internal Medicine (volume 154, pages 719-726). The authors are D. Conen, B.M. Everett, T. Kurth, M.A. Creager, J.E. Buring, P.M Ridker, and A.D. Pradhan.

Ann Intern Med. 2011;154(11):I-28. doi:10.7326/0003-4819-154-11-201106070-00001
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What is the problem and what is known about it so far?

Peripheral artery disease (PAD) is a serious disorder caused by narrowing of the arteries, especially in the legs. It often occurs in persons who have coronary artery disease, a history of heart attacks, or diabetes. Symptoms include pain in the legs or a feeling of tiredness in the leg muscles while walking that may get better or go away if the person rests. Although PAD occurs in both men and women, it is not as widely appreciated that women develop this condition.

Why did the researchers do this particular study?

To see how often women reported a history of PAD and whether smoking increased the chance that a woman would have it. They also wanted to see whether women who stopped smoking were less likely to develop PAD.

Who was studied?

Nearly 40,000 healthy women who participated in the Women's Health Study beginning in 1993. Women were followed for an average of almost 13 years. All the women were aged 45 years or older when the study began, and all were health care professionals. About one half were smokers or former smokers. About one quarter had high blood pressure, and about one third had high cholesterol.

How was the study done?

Twice during the first year of the study and every year thereafter, women filled out a questionnaire about their health that included questions about whether they had ever had symptoms that suggested PAD or had had a procedure known as revascularization that is used to treat PAD. Women who answered “yes” were interviewed by study personnel, and their medical records were reviewed. On the basis of that information, women were classified as having or not having PAD.

What did the researchers find?

The more cigarettes a woman smoked per day, the more likely she was to develop to PAD. Women who stopped smoking were less likely to have PAD than women who continued to smoke. The longer it had been since a woman stopped smoking, the less likely she was to have PAD. However, no matter how long it had been since they quit, women who had ever smoked still had greater risk for PAD than nonsmokers.

What were the limitations of the study?

Only women who reported that they had symptoms of PAD or had been treated for PAD were considered to have the condition. Women who had narrowed arteries but no symptoms would have been missed.

What are the implications of the study?

Peripheral artery disease is fairly common in older women and is much more likely to occur in women who smoke. Stopping smoking decreases a woman's risk for PAD.





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