Exploring gender differences in medication consumption and mortality in a cohort of hypertensive patients in Northern Italy

Abstract

Background This paper aims to assess the presence of gender differences in medication use and mortality in a cohort of patients affected exclusively by hypertension, in 193 municipalities in the Lombardy Region (Northern Italy), including Milan's metropolitan area. Methods A retrospective cohort study was conducted (N = 232,507) querying administrative healthcare data and the Register of Causes of Death. Hypertensive patients (55.4% women; 44.6% men) in 2017 were identified; gender differences in medication use (treatment, 80% compliance) and deaths (from all causes and CVDs) were assessed at two-year follow-ups in logistic regression models adjusted for age class, census-based deprivation index, nationality, and pre-existing health conditions. Models stratified by age, deprivation index, and therapeutic compliance were also tested. Results Overall, women had higher odds of being treated, but lower odds of therapeutic compliance, death from all causes, and death from CVDs. All the outcomes had clear sex differences across age classes, though not between different levels of deprivation. Comparing patients with medication adherence, women had lower odds of death from all causes than men (with a narrowing protective effect as age increased), while no gender differences emerged in non-compliant patients. Conclusions Among hypertensive patients, gender differences in medication consumption and mortality have been found, but the extent to which these are attributable to a female socio-cultural disadvantage is questionable. The findings reached, with marked age-dependent effects in the outcomes investigated, suggest a prominent role for innate sex differences in biological susceptibility to the disease, whereby women would take advantage of the protective effects of their innate physiological characteristics, especially prior to the beginning of menopause.

Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central Portugal

“…In contrast, males adhered more to the treatment and reported a lower frequency of salt consumption. This result is similar to that found in an Italian study about differences in medication consumption of hypertensive patients in which females presented lower therapeutic adherence than males [ 35 ].…”

Awareness of the impact of sex and gender in the disease risk and outcomes in hematology and medical oncology—a survey of Swiss clinicians

“…While many treatment regimens, past and present, are applied intravenously, the current trend towards orally available anticancer treatments might make behavioral differences a critical consideration. Among patients with cardiovascular diseases, such as hypertension, diabetes, and hyperlipidemia, men have been shown to have higher adherence rates than women 54,55 . This could also apply to our patient population, which in turn requires us to consider gender differences more in daily clinical practice.…”

Ups and downs of conducting a national representative survey on hypertension during pandemic time: main results of SEPHAR IV

“…Sex does, in this edition, however, influence the probability of receiving antihypertensive treatment as women are seem to more frequently receive antihypertensive treatment. It is known that women are more likely to seek medical advice and receive treatment [32,33]. This is even more relevant because this edition has shown a lower rate of treatment in male individuals (generating an overall trend of less treatment) compared with the previous edition.…”