title: Sex, Prescribing Practices and Guideline Recommended, Blood Pressure, and LDL Cholesterol Targets at Baseline in the BARI 2D Trial.
abstract: Background. Research has shown less aggressive treatment and poorer control of cardiovascular disease (CVD) risk factors in women than men. Methods. We analyzed sex differences in pharmacotherapy strategies and attainment of goals for hemoglobin A1c (HbA1c), blood pressure (BP), and low density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes and established coronary artery disease enrolled into the BARI 2D trial. Results. Similar numbers of drugs were prescribed in both women and men. Women were less frequent on metformin or sulfonylurea and more likely to take insulin and to be on higher doses of hydroxymethylglutaryl-CoA reductase inhibitors (statins) than men. After adjusting for baseline differences and treatment prescribed, women were less likely to achieve goals for HbA1c (OR = 0.71, 95% CI 0.57, 0.88) and LDL-C (OR = 0.64, 95% CI 0.53, 0.78). More antihypertensives were prescribed to women, and yet BP ≤ 130/80 mmHg did not differ by sex. Conclusions. Women entering the BARI 2D trial were as aggressively treated with drugs as men. Despite equivalent treatment, women less frequently met targets for HbA1c and LDL-C. Our findings suggest that there may be sex differences in response to drug therapies used to treat diabetes, hypertension, and hyperlipidemia.
authors: MedStar Health Research Institute at Washington Hospital Center and Georgetown University School of Medicine, MedStar Diabetes Institute, 100 Irving Street NW, No. 4114, Washington, DC 20010, USA.
authors: Michelle F
authors: MF
authors: Magee
authors: Mount Sinai Saint Luke's Hospital, New York, NY 10025, USA.
authors: Jacqueline E
authors: JE
authors: Tamis-Holland
authors: University of Pittsburgh, Pittsburgh, PA 15261, USA.
authors: Jiang
authors: J
authors: Lu
authors: University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors: Vera A
authors: VA
authors: Bittner
authors: University of Pittsburgh, Pittsburgh, PA 15261, USA.
authors: Maria Mori
authors: MM
authors: Brooks
authors: Heart Institute (InCor), 01238-000 São Paulo, SP, Brazil.
authors: Neuza
authors: N
authors: Lopes
authors: Boston University Medical Center, Boston, MA 02118, USA.
authors: Alice K
authors: AK
authors: Jacobs
authors: University of Pittsburgh, Pittsburgh, PA 15261, USA.