title: Age- and gender-related differences in the use of secondary medical prevention after primary vascular surgery: a nationwide follow-up study.
abstract: OBJECTIVE
  This study examined the possible age- and gender-related differences in the use of secondary medical prevention following primary vascular reconstruction in a population-based long-term follow-up study.
  
  
  METHODS
  Using information from nationwide Danish registers, we identified all patients undergoing primary vascular reconstruction in-between 1996 and 2006 (n = 20,761). Data were obtained on all filled prescriptions 6 months and 3, 5 and 10 years after primary vascular reconstruction. Comparisons were made across age and gender groups, using men 40-60 years old as a reference.
  
  
  RESULTS
  Compared to current guidelines the overall use of secondary medical prevention was moderate to low (e.g., lipid-lowering drugs 49.5%, angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists (ACE/ATII) 43.4%, combination of lipid-lowering drugs and anti-platelet therapy and any anti-hypertensive therapy 44.7%). A decline was observed between 6 months and 3 years after surgery. Patients >80 years old were less likely to be prescribed lipid-lowering drugs and combination therapy (e.g.: adjusted risk ratio (RR) 5 years after surgery for men and women 0.63 (95% confidence interval (CI): 0.39-1.02) and 0.48 (95%CI: 0.31-0.75), respectively, whereas smaller and statistical non-significant gender-related differences were observed. The age- and gender-related differences appeared eliminated or substantially reduced in the latest part of the study period (2001-2007).
  
  
  CONCLUSIONS
  We found moderate to low use of secondary medical prevention in Denmark compared with recommendations from clinical guidelines. However, the use has increased in recent years and age- and gender-related differences have been reduced or even eliminated.
authors.affiliation: Department of Vascular Surgery, Regionshospitalet Viborg, Denmark. a_l_hogh@yahoo.dk
authors.forename: A
authors.initials: A
authors.lastname: Høgh
authors.forename: J S
authors.initials: JS
authors.lastname: Lindholt
authors.forename: H
authors.initials: H
authors.lastname: Nielsen
authors.forename: L P
authors.initials: LP
authors.lastname: Jensen
authors.forename: S P
authors.initials: SP
authors.lastname: Johnsen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000453:epidemiology* / Q000601:surgery*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012042:Registries; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012737:Sex Factors; D014656:Vascular Surgical Procedures / Q000706:statistics & numerical data*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors