Hyperlipidemia guideline adherence and association with patient gender.
BACKGROUND
Gender disparities in cardiovascular disease (CVD) management have become increasingly apparent in recent years. Previous research has focused on inpatient disparities, but little is known about how patient gender affects assessment, treatment, and management of patients for hyperlipidemia and cardiovascular risk in primary care settings. Patients with coronary artery disease (CAD) and hyperlipidemia are at high risk for cardiovascular and cerebrovascular morbidity. We sought to examine the effect of patient gender on assessment, treatment, and target maintenance of hyperlipidemia among patients with CAD in a primary care setting.


METHODS
Chart abstraction was done for 715 patients with CAD in 55 family practices in New Jersey and eastern Pennsylvania as part of the Using Learning Teams for Reflective Adaptation (ULTRA) project. Hyperlipidemia assessment, treatment, and target adherence scores were determined for those at-risk patients based on National Heart, Lung, and Blood Institute (NHLBI) recommended National Cholesterol Education Program (NCEP) ATP III guidelines. Generalized linear models were used to determine the association of hyperlipidemia guideline adherence with patient gender, using comorbidities and age as confounders.


RESULTS
After controlling for comorbidities and age, women were less likely to be assessed for lipids (p = 0.0462). There was no difference in treatment (p = 0.1074) or target laboratory values (p = 0.3949).


CONCLUSIONS
Women with CAD are less often assessed for lipids than men in primary care practices. More intensive efforts may be necessary to educate physicians and patients about cardiovascular risk for women.
Hahn
Karissa A
KA
UMDNJ-Robert Wood Johnson Medical School, Department of Family Medicine, Somerset, New Jersey 08873, USA. clarkeka@umdnj.edu
Strickland
Pamela A Ohman
PA
Hamilton
Jennifer L
JL
Scott
John G
JG
Nazareth
Tara A
TA
Crabtree
Benjamin F
BF
D000328:Adult; D000368:Aged; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis* / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D010414:Pennsylvania / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D016387:Women's Health