Small Calves in Women Make Peripheral Artery Disease Worse


Women with small calves may feel good about their legs, but if they have peripheral artery disease (PAD), those attractive calves could be a detriment. That’s the word from researchers at Northwestern University.

8 million Americans have peripheral artery disease

Peripheral artery disease is a narrowing of the peripheral arteries and most often affects the legs and pelvis. The most common symptoms are cramping, tiredness, or pain in the leg or hip muscles while walking or climbing. PAD places individuals at an increased risk of stroke and heart attack.

Mary McDermott, MD, professor of medicine and of preventive medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital, and her team evaluated 380 men and women who had peripheral artery disease over a four-year period. All the participants had their calf muscles and leg strength measured yearly, as well as their ability to walk for six minutes and climb stairs.


At the end of the four years, McDermott and her team found that “women with PAD were more likely to become unable to walk for six minutes continuously and more likely to develop a mobility disability compared to men with the disease.” The authors believe the gender difference is at least partially associated with calf muscle size.

“When we took into account that the women had less calf muscle than men at the beginning of the study, that seemed to explain at least some of the gender difference,” explained McDermott. Although men showed more loss of calf muscle per year than did the women, the men also had more muscle reserve in their calves, which may have been a protective factor.

Another recent study (Circulation) notes that “it is now established that PAD accelerates functional decline leading to physical disability,” and that exercise, along with secondary prevention (e.g., diet, not smoking) “has the potential to benefit patients with PAD by preserving or improving functional capacity and reducing cardiovascular events.”

It appears that women who have peripheral artery disease should “engage in walking exercise to try and protect against decline,” said McDermott. After all, regular exercise not only improves circulation, it also helps a woman’s small calves look great, too.

American Heart Association
Hamburg NM, Balady GT. Circulation 2011; 123:87-97
Northwestern University