Background Sex differences in the management of cardiovascular disease have been reported in secondary care. We conducted a systematic review with meta‐analysis of systematically investigated sex differences in cardiovascular medication prescription among patients at high risk or with established cardiovascular disease in primary care. Methods and Results PubMed and Embase were searched between 2000 and 2019 for observational studies reporting on the sex‐specific prevalence of aspirin, statins, and antihypertensive medication prescription, including beta blockers, calcium channel blockers, angiotensin‐converting enzyme inhibitors, and diuretics, in primary care. Random effects meta‐analysis was used to obtain pooled women‐to‐men prevalence ratios for each cardiovascular medication prescription. Metaregression models assessed the impact of age and year on the findings. A total of 43 studies were included, involving 2 264 600 participants (28% women) worldwide. Participants’ mean age ranged from 51 to 76 years. The pooled prevalence of cardiovascular medication prescription for women was 41% for aspirin, 60% for statins, and 68% for any antihypertensive medications. Corresponding rates for men were 56%, 63%, and 69% respectively. The pooled women‐to‐men prevalence ratios were 0.81 (95% CI , 0.72–0.92) for aspirin, 0.90 (95% CI , 0.85–0.95) for statins, and 1.01 (95% CI , 0.95–1.08) for any antihypertensive medications. Women were less likely to be prescribed angiotensin‐converting enzyme inhibitors (0.85; 95% CI , 0.81–0.89) but more likely with diuretics (1.27; 95% CI , 1.17–1.37). Mean age, mean age difference between the sexes, and year of study had no significant impact on findings. Conclusions Sex differences in the prescription of cardiovascular medication exist among patients at high risk or with established cardiovascular disease in primary care, with a lower prevalence of aspirin, statins, and angiotensin‐converting enzyme inhibitors prescription in women and a lower prevalence of diuretics prescription in men.

Homozygosity for the interleukin‐6 (IL‐6) g.−174G>C promoter polymorphism has recently been associated with indices of overweight. Homozygous subjects were observed to have reduced energy expenditure, suggesting that lower IL‐6 gene transcription, caused by the IL‐6 g.−174G>C promoter polymorphism, may be associated with obesity. The aim of this study was to investigate the association of this polymorphism with long‐term weight gain. For 334 normal weight (20 < BMI ≤ 25 kg/m2) and 334 obese (BMI > 30 kg/m2) subjects matched by age and sex originating from the population‐based EPIC‐Potsdam Study, recalled weight change from age 25 to study enrollment was determined, the IL‐6 g.–174G>C promoter polymorphism was defined, and plasma concentrations of IL‐6 and C‐reactive protein were measured. The IL‐6 g.−174G>C promoter polymorphism was significantly associated with obesity (χ2 = 7, 34, p = 0.026). Odds ratios for subjects with GC and CC genotypes for obesity were 1.19 (95% CI: 0.84 to 1.68; p = 0.323) and 1.91 (95% CI: 1.19 to 3.08; p = 0.007), respectively. Recalled weight change from age 25 years to study enrollment differed significantly according to genotype (p = 0.044) and was most pronounced in subjects with the CC genotype, suggesting that the IL‐6 g.−174G>C promoter polymorphism is a susceptibility or modifying locus for common obesity and weight gain.

Background HIV is associated with an increased risk of cardiovascular disease ( CVD ) in high‐income countries. Little is known about the CVD burden in sub‐Saharan Africa, where 70% of the world's HIV ‐positive population lives. This study aims to provide insight into the burden of CVD risk in a rural setting in sub‐Saharan Africa considering HIV infection and antiretroviral therapy ( ART ). Methods and Results A cross‐sectional analysis was conducted of the baseline of the Ndlovu Cohort study including HIV ‐negative and HIV ‐positive participants in rural South Africa between 2014 and 2017. Information was collected on demographics, socioeconomic status, and CVD risk factors. Carotid intima‐media thickness measurement was performed. The influence of HIV and ART on the burden of CVD was determined by comparing HIV ‐positive participants who were ART naive on first‐line or second‐line ART with HIV ‐negative participants. In total, 1927 participants were included, of whom 887 (46%) were HIV positive and 54% women. The median age was 38 years. Overall, 690 participants (79%) were on ART , with 613 (89%) on first‐line and 77 (11%) on second‐line therapy. Participants with HIV had lower values for most of the CVD risk factors but higher C‐reactive protein levels than HIV ‐negative participants. ART ‐naive, HIV ‐positive participants had similar carotid intima‐media thickness compared with HIV ‐negative participants but carotid intima‐media thickness was increased for participants on ART aged 30 years and older compared with HIV ‐negative participants. Conclusions HIV ‐positive participants presented with a favorable CVD risk profile compared with HIV ‐negative participants. However, carotid intima‐media thickness was increased in HIV ‐positive participants on ART , indicating a higher burden of subclinical CVD for the HIV ‐positive population.