Are Women Less Likely to Have CVD Risk Factors Measured?
Women attending primary health care services in Australia were less likely than men to have cardiovascular disease risk factors recorded, according to a study published March 1 in Heart.
Karice K. Hyun, et al, analyzed baseline data from the TORPEDO study between September 2011 and May 2012. Of 53,085 patients, 58 percent were female. Thirty percent were at high cardiovascular disease risk, which was defined as the patient having any of the following: diabetes mellitus and age >60 years, diabetes mellitus and albuminuria, chronic kidney disease or extreme individual risk factor elevations.
Results showed that overall, 43 percent of patients had all necessary cardiovascular disease risk factors recorded for absolute risk assessment, with women less likely than men to have the risks recorded (41.4 percent vs. 45.9 percent, respectively). Women were significantly less likely to have smoking status, systolic blood pressure, total cholesterol, HDL cholesterol and body mass index recorded compared with men. When rates of risk factor assessment were compared within age groups, where there were significant differences between women and men, women were consistently less likely to have their risk measured than men.
In the high cardiovascular disease risk group, women and men were prescribed recommended medications in similar proportions (46.9 percent vs. 48 percent). Younger women (35-54) were 37 percent less likely to be prescribed recommended medications than their male peers. Older women were 34 percent more likely to be prescribed medications than men the same age. The authors note that this suggests the "possible presence of age stereotypes in medical management of cardiovascular disease."
"Despite guidelines … regarding screening for cardiovascular disease risk factors, inequality in cardiovascular disease prevention through assessing risk factors remains between women and men," the authors conclude. "This indicates that strategies and incentives are needed at the system level, together with education of physicians and public about this inequality at the individual and social level, to minimize the treatment gap between women and men."
In an accompanying editorial, Lauren E. Thompson, MD, and Stacie L. Daugherty, MD, FACC, point out that the study "adds to the growing evidence that many of the gender differences seen in cardiovascular disease care are age dependent." They add that moving forward, "comparing whether gender differences in risk estimation and management seen at enrollment into TORPEDO persisted at the end of the trial will improve our understanding of ways to potentially address gender disparities in care."
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