Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare

Hyun, Karice; Redfern, Julie; Patel, Anushka; Peiris, David; Brieger, David; Sullivan, David; Harris, Mark F; Usherwood, Tim; MacMahon, Stephen; Lyford, Marilyn; Woodward, Mark

doi:10.1136/heartjnl-2016-310216

Cited by 105 publications

(111 citation statements)

References 14 publications

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“…We observed effects on age, sex, race, and comorbidity that we controlled for in the assessment of effects on health outcomes. Female patients had a slightly greater risk of death than men that may be related to less attention to cardiovascular risk factors and lower prescribing of effective medications in women than in men . The effects of race on mortality and utilization outcomes could be the result of variation in cardiovascular medication prescribing to racial and ethnic minorities and their adherence to treatments …”

Section: Discussionmentioning

confidence: 99%

Association Between Medication Adherence and the Outcomes of Heart Failure

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Association Between Medication Adherence and the Outcomes of Heart Failure

et al. 2018

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“…70 Gender disparities in CVD prevention are age dependent, as shown by an analysis of the Treatment of cardiovascular Risk in Primary care using Electronic Decision suppOrt (TORPEDO) study. 71 Women attending primary healthcare services in Australia were less likely than men to have risk factors measured and recorded such that absolute CVD risk can be assessed. For those with, or at high risk of, CVD, the prescription of appropriate preventive medications was more frequent in older women but less frequent in younger women, compared with their male counterparts.…”

Section: Other Relevant Groupsmentioning

confidence: 99%

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Piepoli

Abreu

Albus

et al. 2019

Eur J Prev Cardiolog

179

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European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.

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“…Women are less likely than men to have their cardiac risks assessed, with the majority not adhering to appropriate primary prevention guidelines and instead resorting to nonevidence-based therapies. 45,46,79 Similarly, EUROASPIRE III and IV surveys demonstrated that despite the higher burden of comorbidities at time of presentation of MI, women are less likely to receive recommended pharmacotherapies (Figure 4) 47,48 and less likely to achieve secondary prevention targets for hyperlipidemia (OR, 0.5), hyperglycemia (OR 0.78), physical activity (OR, 0.74), or body mass index (OR, 0.82). 47,51,52 These disparities are most prominent in Black women, the majority of whom have ≥3 traditional risk factors and yet are significantly less likely to receive appropriate secondary prevention compared with age-matched White women after hospitalization for MI.…”

Section: Less Intense Pharmacotherapymentioning

confidence: 99%

Sex Differences in Ischemic Heart Disease

Aggarwal

Patel

Mehta

et al. 2018

Circ: Cardiovascular Quality and Outcomes

229

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Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled "Women's Health Research-Progress, Pitfalls, and Promise," highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment. These important health disparities reflect underrepresentation of women in research, with the resultant unfavorable impact on diagnosis, prevention, and treatment strategies in women at risk for cardiovascular disease. Causes of disparities are multifactorial and related to differences in risk factor prevalence, access to care, use of evidence-based guidelines, and social and environmental factors. Lack of awareness in both the public and medical community, as well as existing knowledge gap regarding sex-specific differences in presentation, risk factors, pathophysiology, and response to treatment for ischemic heart disease, further contribute to outcome disparities. There is a critical need for implementation of sex-and gender-specific strategies to improve cardiovascular outcomes. This review is tailored to meet the needs of a busy clinician and summarizes the contemporary trends, characterizes current sex-specific outcome disparities, delineates challenges, and proposes transformative solutions for improvement of the full spectrum of ischemic heart disease clinical care and research in women.by guest on May 7, 2018

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Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare

Abstract: 12611000478910, Pre-results.

Cited by 105 publications

References 14 publications

Association Between Medication Adherence and the Outcomes of Heart Failure

Association Between Medication Adherence and the Outcomes of Heart Failure

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Sex Differences in Ischemic Heart Disease

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