More women than men missing out of CVD risk-factor management

January 01, 0001

More women than men missing out of CVD risk-factor management

Patients with established coronary heart disease (CHD) are at the highest risk of further events. Despite proven therapies, secondary prevention is often suboptimal. General practitioners (GPs) are in an ideal position to improve secondary prevention. The aim of this study by researchers from Australia was to contrast management of cardiovascular risk factors in patients with established CHD in primary care to those in clinical guidelines and according to gender. GPs throughout Australia were approached to participate in a programme incorporating a disease management software (mdCare) program. Participating practitioners (1258 GPs) recruited individual patients whose cardiovascular risk factor levels were measured. The mdCare programme included 12,509 patients (58% male) diagnosed with CHD. Their mean age was 71.7 years for men and 74 years for women.

Low-density-lipoprotein cholesterol was significantly above target levels in 69% of women compared with 58% in men. There was also a higher proportion of women with total cholesterol above target levels (76%) compared with men (57%). In patients who were prescribed lipid-lowering medication, 53% of men and 72% of women continued to have a total cholesterol higher than recommended target levels. Overall, over half (52%) had at least five cardiovascular risk factors (55% in women and 50% in men, significant).

The researchers concluded: "This study found less intensive management of cardiovascular risk factors in CHD patients, particularly among women, despite equivalent cardiovascular risk. This study has shown that these patients have multiple risk factors where gender also plays a role."

Even the figures for men don’t look great, but women appear to be missing out.

For the full abstract, click here.

Internal Medicine Journal 41(10):730-736, October 2011 © 2011 The Authors. Internal Medicine Journal
Suboptimal management of cardiovascular risk factors in coronary heart disease patients in primary care occurs particularly in women. Driscoll, A. Beauchamp, G. Lyubomirsky et al.

Category: K. Circulatory. Keywords: coronary heart disease, primary care, risk factors, management, cross-sectional cohort study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 4 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.