Sex-based differences in medicine are not a new issue – and yet the evidence keeps mounting: women not only receive different diagnoses but are also diagnosed later or not at all. This becomes especially clear in vascular diseases such as peripheral arterial disease (PAD). Studies show that women are significantly more likely to be underdiagnosed and undertreated – with serious consequences for both prevention and therapy. In this article we are going to examine the Gender Diagnostic Gap as it appears in vascular diagnostics.
Undetected PAD: A Gender-Specific Challenge
According to a 2021 press release by the European Society of Cardiology (ESC), blocked or narrowed leg arteries (PAD of the lower extremities) are less frequently detected and treated in women than in men – even when symptoms are similar or more severe¹. Women are referred to vascular specialists less often, undergo fewer imaging procedures, and are less likely to receive medication. A clear indication that disparities in care based on sex still persist.
Symptoms Are Perceived and Evaluated Differently: The Gender Diagnostic Gap
A central issue: women with PAD often present with atypical or less specific symptoms. While men typically report pain while walking (claudication), women are more likely to describe diffuse discomfort or fatigue. A study published in the Journal of the American Heart Association highlights that women are diagnosed later because their symptoms are often interpreted differently – even by physicians themselves².
This delay in diagnosis means women are often only treated in more advanced stages of the disease – with significantly higher risks for complications such as chronic wounds or amputations.
Biological Differences in Vascular Structure?
Structural factors may also play a role: a systematic review published in 2024 suggests that female patients may have different pathophysiological characteristics in peripheral circulation³. These differences could impact standard diagnostic methods – such as the Ankle-Brachial Index (ABI) – and result in false-negative outcomes.
All of this underlines the need to adapt diagnostics and interpretation more closely to the individual patient – including biological sex.
What Does The Gender Diagnostic Gap Mean for Clinical Practice?
For physicians and clinical staff, this means one thing above all: awareness. If PAD manifests differently in women, symptoms need to be questioned more carefully and findings interpreted more sensitively. Preventive vascular health checks should be implemented as early and as accessibly as possible – regardless of gender.
Modern systems such as the AngE™ ABI+ offer key advantages:
- Fast, painless vascular screening in under one minute
- Blood pressure-independent results – even in patients with arterial stiffening
- Delegable use, ideal for structured screening programs
This allows vascular risks – in both men and women – to be efficiently identified and addressed early.
Conclusion: Gender-Sensitive Diagnostics Is Prevention
That women are more often underdiagnosed in vascular medicine is not an individual oversight – it’s a systemic issue. What’s needed is more awareness, better data, and a stronger integration of gender-specific factors in diagnostic routines.
With modern, delegable screening technologies, many of these barriers – and the gender diagnostic gap – can be overcome.
Would you like to learn more about how our diagnostic systems support gender-sensitive vascular screening and prevention? Don’t hesitate to reach out – we’d love to hear from you.
Sources:
1ESC Press Release: Clogged leg arteries underdiagnosed and undertreated in women
2Jelani QU, Petrov M, Martinez SC, Holmvang L, Al-Shaibi K, Alasnag M. Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile, Clinical Features, and Outcomes. Curr Atheroscler Rep. 2018 Jun 2;20(8):40. – Download
3Farkas, K.; Stanek, A.; Zbinden, S.; Borea, B.; Ciurica, S.; Moore, V.; Maguire, P.; Abola, M.T.B.; Alajar, E.B.; Marcoccia, A.; et al. Vascular Diseases in Women: Do Women Suffer from Them Differently? J. Clin. Med. 2024, 13, 1108. – Download
