Are at-risk New Zealand women receiving recommended cardiovascular preventive therapy?
OBJECTIVE
To determine whether use of cardiovascular medications by a sample of mid-life and older women is consistent with New Zealand cardiovascular risk guidelines.


METHODS
Retrospective analysis of risk factor data collected during the Women's Lifestyle Study involving 1089 40-74 year old women. Outcome measures included: 5-year cardiovascular (CVD) risk score calculated using the adjusted Framingham equation and self-reported use of cardiovascular medications.


RESULTS
Seven percent (76/1089) of women had established CVD, and a further 3% (33/1089) had a risk score greater than 15% (high risk). Of the 109 women at high risk (risk score = or >15% or established CVD); 36% (39/109) were taking aspirin, 55% (60/109) were taking blood pressure-lowering medication, 45% (49/109) were taking lipid-lowering medications and 17% (19/109) were taking all three medications. Triple therapy was being taken by 12% of women (4/33) for primary prevention (5-year risk score = or >15%) and only 19.7% of women for secondary prevention (15/76).


CONCLUSIONS
These results suggest that women at high-risk are not receiving cardiovascular medications as recommended by the guidelines, reflecting a 'treatment gap.' Modifiable barriers to the management of women at risk for CVD need to be identified and addressed to reduce cardiovascular morbidity and mortality among women.
Bupha-Intr
Olivia
O
Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
Rose
Sally B
SB
Lawton
Beverley A
BA
Elley
C Raina
CR
Dowell
Anthony C
AC
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005006:Ethnicity; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention
D000959:Antihypertensive Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin