title: Persisting gender differences and attenuating age differences in cardiovascular drug use for prevention and treatment of coronary heart disease, 1998-2010.
abstract: BACKGROUND
  Evidence on recent time trends in age-gender differences in cardiovascular drug use is scarce. We studied time trends in age-gender-specific cardiovascular drug use for primary prevention, secondary prevention, and in-hospital treatment of coronary heart disease.
  
  
  RESULTS
  The PHARMO database was used for record linkage of drug dispensing, hospitalization, and population data to identify drug use between 1998 and 2010 in 1 203 290 persons ≥25 years eligible for primary prevention, 84 621 persons hospitalized for an acute coronary syndrome (ACS), and 15 651 persons eligible for secondary prevention. The use of cardiovascular drugs increased over time in all three settings. In primary prevention, the proportion of women that used lipid-lowering drugs was lower than men between 2003 and 2010 (5.7 vs. 7.3% in 2010). The higher proportion of women that used blood pressure-lowering drugs for primary prevention, compared with men, attenuated over time (15.1 vs. 13.8% in 2010). During hospital admission for an ACS, the proportion of women that used cardiovascular drugs was lower than men. In secondary prevention (36 months after hospital discharge), drug use was lowest in young women. The proportion receiving lipid-lowering drugs declined after the age of 75 in all three settings. This age difference attenuated over time.
  
  
  CONCLUSIONS
  Age differences in drug use tended to attenuate over time, whereas gender differences persisted. Areas potentially for improvement are in the hospital treatment of ACS in young women, in secondary prevention among young women and the elderly, and in the continuity of drug use in secondary prevention.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (STR 6.131), PO Box 85500, Utrecht 3508 GA, The Netherlands.
authors.forename: Carla
authors.initials: C
authors.lastname: Koopman
authors.forename: Ilonca
authors.initials: I
authors.lastname: Vaartjes
authors.forename: Edith M
authors.initials: EM
authors.lastname: Heintjes
authors.forename: Wilko
authors.initials: W
authors.lastname: Spiering
authors.forename: Ineke
authors.initials: I
authors.lastname: van Dis
authors.forename: Ron M C
authors.initials: RM
authors.lastname: Herings
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy* / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D054625:Healthcare Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011322:Primary Prevention / Q000379:methods; D055502:Secondary Prevention / Q000379:methods; D017678:Sex Distribution
chemical_list: D002317:Cardiovascular Agents
keywords: Age; Cardiovascular drugs; Coronary heart disease; Gender; Prevention; Trends