Sex and Reproductive History as Nontraditional Risk Factors for PAD

Sex and reproductive history are established nontraditional risk factors for cardiovascular disease, but their relevance for peripheral artery disease (PAD) remains unclear. This narrative review examines the current evidence surrounding underlying mechanisms and associations between female sex, reproductive factors, and the development of atherosclerosis, focusing on PAD specifically. Overall, there is a paucity of evidence regarding the association between sex-specific risk factors and PAD. However, hypertensive disorders of pregnancy, gestational diabetes, and adverse pregnancy outcomes are significantly associated with increased incident PAD. Further work is needed to improve the mechanistic understanding of associations between sex-specific risk factors and PAD. In addition, increased clinician awareness may facilitate earlier risk factor detection and preventative strategies. In future, integrating reproductive history into cardiovascular risk assessment may enable more personalized care and ultimately reduce PAD burden among women.