TY - JOUR KW - Adult KW - Female KW - Humans KW - Aged KW - Male KW - Odds Ratio KW - Treatment Outcome KW - Middle Aged KW - Risk Factors KW - Risk Assessment KW - Time Factors KW - Age Factors KW - New South Wales KW - Cardiovascular Diseases KW - Randomized Controlled Trials as Topic KW - Guideline Adherence KW - Practice Guidelines as Topic KW - Multivariate Analysis KW - Logistic Models KW - Sex Factors KW - Decision Support Techniques KW - Healthcare Disparities KW - Primary Health Care KW - Queensland KW - Hydroxymethylglutaryl-CoA Reductase Inhibitors KW - Antihypertensive Agents KW - Platelet Aggregation Inhibitors KW - Anticoagulants KW - Chi-Square Distribution KW - Drug Prescriptions KW - Practice Patterns, Physicians' KW - Primary Prevention AU - Woodward Mark AU - Patel Anushka AU - D Peiris AU - Redfern Julie AU - Usherwood Tim AU - Brieger David AU - Hyun Karice AU - Sullivan David AU - Harris Mark AU - Lyford Marilyn AU - Macmahon S AB -

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.

BT - Heart C1 - https://www.ncbi.nlm.nih.gov/pubmed/28249996?dopt=Abstract DO - 10.1136/heartjnl-2016-310216 IS - 7 J2 - Heart LA - eng N2 -

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.

PY - 2017 SP - 492 EP - 498 T2 - Heart TI - Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare. VL - 103 SN - 1468-201X ER -