@article{22958, keywords = {Adult, Female, Humans, Aged, Male, Odds Ratio, Treatment Outcome, Middle Aged, Risk Factors, Risk Assessment, Time Factors, Age Factors, New South Wales, Cardiovascular Diseases, Randomized Controlled Trials as Topic, Guideline Adherence, Practice Guidelines as Topic, Multivariate Analysis, Logistic Models, Sex Factors, Decision Support Techniques, Healthcare Disparities, Primary Health Care, Queensland, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Antihypertensive Agents, Platelet Aggregation Inhibitors, Anticoagulants, Chi-Square Distribution, Drug Prescriptions, Practice Patterns, Physicians', Primary Prevention}, author = {Woodward Mark and Patel Anushka and D Peiris and Redfern Julie and Usherwood Tim and Brieger David and Hyun Karice and Sullivan David and Harris Mark and Lyford Marilyn and Macmahon S}, title = {Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare.}, abstract = {

OBJECTIVES: To quantify contemporary differences in cardiovascular disease (CVD) risk factor assessment and management between women and men in Australian primary healthcare services.

METHODS: Records of routinely attending patients were sampled from 60 Australian primary healthcare services in 2012 for the Treatment of Cardiovascular Risk using Electronic Decision Support study. Multivariable logistic regression models were used to compare the rate of CVD risk factor assessment and recommended medication prescriptions, by gender.

RESULTS: Of 53 085 patients, 58% were female. Adjusting for demographic and clinical characteristics, women were less likely to have sufficient risk factors measured for CVD risk assessment (OR (95% CI): 0.88 (0.81 to 0.96)). Among 13 294 patients (47% women) in the CVD/high CVD risk subgroup, the adjusted odds of prescription of guideline-recommended medications were greater for women than men: 1.12 (1.01 to 1.23). However, there was heterogeneity by age (p <0.001), women in the CVD/high CVD risk subgroup aged 35-54 years were less likely to be prescribed the medications (0.63 (0.52 to 0.77)), and women in the CVD/high CVD risk subgroup aged ≥65 years were more likely to be prescribed the medications (1.34 (1.17 to 1.54)) than their male counterparts.

CONCLUSIONS: 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.

TRIAL REGISTRATION NUMBER: 12611000478910, Pre-results.

}, year = {2017}, journal = {Heart}, volume = {103}, pages = {492-498}, issn = {1468-201X}, doi = {10.1136/heartjnl-2016-310216}, language = {eng}, }