Gender differences in secondary prevention of coronary heart disease: reasons to worry or not?
OBJECTIVE
To analyse potential gender differences in cardiovascular risk factors and treatment patterns, reflecting clinical practice in secondary prevention.


METHODS
Observational national study during 3 years of patients eligible for secondary prevention of coronary heart disease (CHD).


METHODS
Fifty-two healthcare districts in Sweden, involving primary health care and hospitals in collaboration, participating in a national quality assurance programme for the prevention of CHD.


METHODS
A national sample of male and female patients surviving acute myocardial infarction, or following CABG/PTCA interventions for CHD, controlled at 3-6 months (n = 9135) and 12 months (n = 4802) of follow-up. The proportion of female patients (25%) did not differ between visits.


METHODS
Self-reported data on lifestyle, drug treatment and cardiovascular risk factor levels after consultation in general practice or at hospital policlinics.


RESULTS
No major gender differences were recorded in risk factor levels or in cardiovascular drug treatment patterns at 12 months of follow-up. Female patients participated in educational programmes to improve lifestyle to a higher degree than males (52.0 vs 45.1%), but after 1 year were more often (p < 0.001) self-reported smokers (11.7 vs 8.4%). Female patients showed higher levels of blood pressure, total cholesterol and HDL cholesterol, but not LDL cholesterol compared to male patients.


CONCLUSIONS
In general, a gender-equal level of lipid control and access to medical drug treatment has been established for patients in secondary prevention from a national sample in Sweden, followed for 1 year after CHD manifestations and related interventions.
Nilsson
Peter
P
Department of Medicine, University Hospital, Malmö, Sweden. Peter.Nilsson@medforsk.mas.lu.se
Brandström
Hans
H
Lingfors
Hans
H
Erhardt
Leif
L
Hedbäck
Bo
B
Israelsson
Bo
B
Sjöberg
Gunilla
G
D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D040242:Risk Reduction Behavior; D020377:Self Efficacy; D012737:Sex Factors; D013548:Sweden
D008055:Lipids