Gender differences in achieving optimal lipid goals in patients with coronary artery disease.
To investigate gender differences in lipid goal attainment, we conducted a retrospective analysis of outpatient electronic health records from a large cardiology practice from September 2008 to September 2009. The most recent lipid profile and lipid-lowering medications and doses were extracted from electronic medical record. We identified 9,950 patients with coronary artery disease of whom 3,366 (34%) were women. Women were less likely to achieve a low-density lipoprotein (LDL) cholesterol goal of <70 mg/dl compared with men (30.6% vs 38.4%, p <0.001) and less likely to achieve a non-high-density lipoprotein cholesterol goal of <100 mg/dl (37.1% vs 48.2%, p <0.001). Irrespective of age, women were less likely to achieve their LDL cholesterol goals. Compared with men, women were more likely to be on no statin (16.9% vs 11.6%, p <0.001) or any lipid-lowering therapy (12.8% vs 7.8%, p <0.001) and less likely to be on high-potency statin (14.9% vs 18.0%, p <0.001) or combination therapy (22.2% vs 30.1%, p <0.001). There exists a major difference in the use of lipid-lowering therapy between men and women with coronary artery disease. In conclusion, women with coronary artery disease are prescribed insufficient doses of statins and combination lipid-lowering therapy and are less likely to achieve their optimal LDL and non-high-density lipoprotein cholesterol goals.
Departments of Medicine and Cardiology, University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pennsylvania.
Brett M
BM
Victor
Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania.
Valerie
V
Teal
Departments of Medicine and Cardiology, Northwestern Lake Forest Hospital, Lake Forest, Illinois.
Lilian
L
Ahedor
Departments of Medicine and Cardiology, University of Pennsylvania Health System, Pennsylvania Hospital, Philadelphia, Pennsylvania. Electronic address: dean.karalis@uphs.upenn.edu.
Dean G
DG
Karalis
D000368:Aged; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D010045:Outpatients; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008055:Lipids