Gender differences in evidence-based pharmacological therapy for patients with stable coronary heart disease.
BACKGROUND
Women have a higher morbidity and mortality than men after an acute coronary event. We analyzed the prescription rates of evidence-based pharmacological therapies for patients with stable coronary heart disease and whether there were any differences with respect to gender.


METHODS
This cross-sectional study evaluated 8817 patients, 26.3% women, receiving attention from 1799 family doctors in primary care centers (PCC) throughout Spain, and who had had a coronary event requiring hospitalization in the previous 6 months to 10 years.


RESULTS
Mean age was 65.4 years and a mean time-lapse since hospitalization of 37.4 months. In the overall population, prescription medications were: antiplatelet drugs in 80.5% of patients, 79% statins, 66% blockers of the angiotensin-renin system (BARS) and 47% beta-blockers. Males received less cardiovascular disease medications than females (4.3+/-1.5 versus 4.6+/-1.6, respectively; p<0.001), but when adjusted for risk factors the significance was lost (p=0.231). Following adjustment for risk factors and for co-morbidities, the use of diuretics was significantly higher in women while beta-blockers and statins were higher in men. The triple combination of antithrombotics, beta-blockers and statins was used in 41.4% (43.8% males versus 34.6% females; p<0.001) while 24.3% used this triple combination plus a BARS; without significant difference between the genders.


CONCLUSIONS
An important percentage of patients with stable coronary disease, particularly women, attended-to in primary care do not receive medications that have been shown to decrease the morbido-mortality of cardiovascular disease.
Lahoz
Carlos
C
Hospital Carlos III, Madrid, Spain. clahoz.hciii@salud.madrid.org
Mantilla
Teresa
T
Taboada
Manuel
M
Soler
Begoña
B
Tranche
Salvador
S
López-Rodriguez
Isidro
I
Monteiro
Beatriz
B
Martin-Jadraque
Raquel
R
Sanchez-Zamorano
Miguel A
MA
Mostaza
Jose M
JM
D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics
D002317:Cardiovascular Agents