Age and gender biases in secondary prevention of coronary heart disease in a Finnish university hospital setting.
OBJECTIVE
Several studies have shown that treatment of coronary heart disease (CHD) does not meet the goals set in recommendations. The aim of this study was to investigate the adequacy of CHD drug treatment and secondary prevention measures, particularly with respect to age and gender biases, in a Finnish university hospital setting.


METHODS
The participant pool consisted of patients in FINCAVAS (Finnish Cardiovascular Study), which is a cohort study recruiting consecutive patients performing a clinical exercise test at Tampere University Hospital, Tampere, Finland. 802 patients (581 men, 221 women) with a prior diagnosis of CHD recruited between October 2001 and December 2004 were included in the analysis.


RESULTS
Only roughly 12% of both men and women had an optimal risk factor profile. High blood pressure and hypercholesterolaemia were more common in women than in men, whereas smoking was more frequent among men. Men used ACE inhibitors (32.9% vs 20.4%, respectively), beta-adrenoceptor antagonists (80.8% vs 68.3%, respectively) and aspirin (acetylsalicylic acid) [69.7% vs 58.8%, respectively] more frequently than women, but the frequency of use of these medications was also not at the recommended levels in men. Risk factor control is poorer in older than younger age groups.


CONCLUSIONS
CHD patients, particularly women, who performed an exercise stress test in a university hospital are suboptimally treated.
Michou
Sanna-Maria
SM
Department of Pharmacological Sciences, Medical School, University of Tampere, Tampere, Finland.
Kähönen
Mika
M
Lehtimäki
Terho
T
Nikus
Kjell
K
Viik
Jari
J
Niemelä
Kari
K
Kallio
Janne
J
Lehtinen
Rami
R
Kööbi
Tiit
T
Turjanmaa
Väinö
V
Nieminen
Tuomo
T
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003327:Coronary Disease / Q000517:prevention & control*; D005080:Exercise Test; D005260:Female; D005387:Finland; D006785:Hospitals, University; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking