title: Differences in management and outcomes between male and female patients with atherothrombotic disease: results from the REACH Registry in Europe.
abstract: BACKGROUND
  Although guidelines recommend similar evaluation and treatment for both sexes, differences in approach and outcomes have been reported.
  
  
  METHODS
  Prospective, observational registry.
  
  
  METHODS
  Consecutive patients at high cardiovascular risk were assessed for risk factors and management at baseline,and followed-up for 2 years.
  
  
  RESULTS
  Twenty-two thousand and twenty-eight patients with documented arterial disease (symptomatic) or three or more atherothrombotic risk factors (asymptomatic) completed the 2-year follow-up of the REduction of Atherothrombosis for Continued Health Registry in Europe (women, 31.5%; men, 68.4%). Women patients were 3.3 years (mean) older than men. Few differences were observed between asymptomatic men and women in risk factor profile or management at baseline. Higher proportions of symptomatic women than men had diabetes (P<0.001), hypertension (P<0.0001), elevated total cholesterol levels (P<0.0001) or elevated triglycerides (P<0.01). A much lower proportion of women than men were current smokers (asymptomatic, 14.6 vs. 29.3%; symptomatic, 11.9 vs.19.5%, both P<0.0001). Within the symptomatic population, women received antithrombotic agents (91.8 vs. 94.9%,P<0.0001) and lipid-lowering agents (68.2 vs. 73.1%, P<0.0001) less frequently than men. After multivariate adjustment,fewer symptomatic women than men had undergone coronary revascularizations at 2 years (odds ratio, 0.72; 95% confidence interval, 0.61-0.85). There were no differences in primary outcomes, including cardiovascular death/myocardial infarction/stroke (odds ratio, 1.01, 95% confidence interval, 0.93-1.11, P=0.78), between the sexes.
  
  
  CONCLUSIONS
  Although no differences were found in cardiovascular event rates at 2-year follow-up, secondary prevention could be improved in women, which might further reduce event rates.
authors.affiliation: Conquest Hospital, St Leonards-on-Sea, East Sussex, UK. Drjmmorrell@aol.com
authors.forename: Jonathan
authors.initials: J
authors.lastname: Morrell
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Iris
authors.initials: I
authors.lastname: Baumgartner
authors.forename: Tobias
authors.initials: T
authors.lastname: Limbourg
authors.forename: Joachim
authors.initials: J
authors.lastname: Röther
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Ph Gabriel
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D005060:Europe / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D054625:Healthcare Disparities; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013927:Thrombosis / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents