title: Sex-based disparities in cardioprotective medication use in adults with diabetes.
abstract: OBJECTIVE
  The identification of sex-based disparities in the use of effective medications in high-risk populations can lead to interventions to minimize disparities in health outcomes. The objective of this study was to determine sex-specific rates of cardioprotective medication use in a large population-level administrative-health database from a universal-payer environment.
  
  
  METHODS
  This observational, population-based cohort study used provincial administrative data to compare the utilization of cardioprotective medications between women and men in the first year following a diabetes diagnosis. Competing risks regression was used to calculate crude and adjusted sub-hazard ratios for time-to-first angiotensin-converting-enzyme inhibitor, angiotensin receptor blocker, or statin dispensations.
  
  
  RESULTS
  There were 15,120 (45.4%) women and 18,174 (54.6%) men with diabetes in the study cohort. Overall cardioprotective medication use was low for both primary and secondary prevention for both women and men. In the year following a diabetes diagnosis, women were less likely to use a statin relative to men (adjusted sub-hazard ratio [aSHR] 0.90, 95% confidence interval [CI] 0.85 to 0.96), angiotensin-converting-enzyme inhibitors (aSHR 0.90, 95% CI 0.86 to 0.94), or any cardioprotective medication (aSHR 0.93, 95% CI 0.90 to 0.97).
  
  
  CONCLUSIONS
  Cardioprotective medication use was not optimal in women or men. We also identified a health care gap with cardioprotective medication use being lower in women with diabetes compared to men. Closing this gap has the potential to reduce the impact of cardiovascular disease in women with diabetes.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada ; Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7 Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Butalia
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Adriane M
authors.initials: AM
authors.lastname: Lewin
authors.affiliation: Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta Canada.
authors.forename: Scot H
authors.initials: SH
authors.lastname: Simpson
authors.affiliation: Department of Medicine, McGill University, Montreal, Quebec Canada ; >Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec Canada ; Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Quebec Canada.
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
authors.affiliation: Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Khan
authors.affiliation: Department of Medicine, McGill University, Montreal, Quebec Canada ; Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Quebec Canada.
authors.forename: Louise
authors.initials: L
authors.lastname: Pilote
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Alberta Canada.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: William A
authors.initials: WA
authors.lastname: Ghali
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada ; Department of Cardiac Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta Canada.
authors.forename: Doreen M
authors.initials: DM
authors.lastname: Rabi