title: The gender gap in risk factor control: Effects of age and education on the control of cardiovascular risk factors in male and female coronary patients. The EUROASPIRE IV study by the European Society of Cardiology.
abstract: OBJECTIVE
  The aim of this study was to investigate gender related differences in the management and risk factor control of patients with coronary heart disease (CHD), taking into account their age and educational level.
  
  
  METHODS
  Analyses are based on the EUROASPIRE IV (EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events) survey. Males and females between 18 and 80years of age, hospitalized for a first or recurrent coronary event were included in the study.
  
  
  RESULTS
  Data were available for 7998 patients of which 75.6% were males. Overall, females had a worse risk factor profile compared to males and were more likely to have 3 or more risk factors (29.5% vs. 34.9%; p<0.001) across all age groups. A significant gender by education interaction (p<0.05) and gender by age interaction effect (p<0.05) was found. Furthermore, males were more likely to have a LDL-cholesterol on target (OR=1.50[1.28-1.76]), a HbA1c on target (OR=1.33[1.07-1.64]), to be non-obese (OR=1.45[1.30-1.62]) and perform adequate physical activity (OR=1.71[1.46-2.00]). In contrast males were less likely to be non-smokers (OR=0.71[0.60-0.83]). Furthermore, males were less likely to have made a dietary change (OR=0.78[0.64-0.95]) or a smoking cessation attempt (OR=0.70[0.50-0.96]) and more likely to have received smoking cessation advice if they were smokers (OR=1.52[1.10-2.09]).
  
  
  CONCLUSIONS
  Whereas gender differences in CHD treatment are limited, substantial differences were found regarding target achievement. The largest gender difference was seen in less educated and elderly patients. The gender gap declined with decreasing age and higher education.
authors.affiliation: Department of Public Health, Ghent University, Gent, Belgium. Electronic address: Delphine.desmedt@ugent.be.
authors.forename: Delphine
authors.initials: D
authors.lastname: De Smedt
authors.affiliation: Department of Public Health, Ghent University, Gent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Bacquer
authors.affiliation: Department of Cardiology, AZ Maria Middelares Gent, Gent, Belgium; Department of Internal Medicine, Ghent University, Gent, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: De Sutter
authors.affiliation: Unité d'Epidémiologie et de Santé Publique, Institut Pasteur de Lille, Lille, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.affiliation: Department of Cardiology, Ghent University Hospital, Gent, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Gevaert
authors.affiliation: Department of Public Health, Ghent University, Gent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: De Backer
authors.affiliation: Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bruthans
authors.affiliation: Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
authors.forename: Kornelia
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine University of Zagreb, Croatia.
authors.forename: Željko
authors.initials: Ž
authors.lastname: Reiner
authors.affiliation: Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoğlu
authors.affiliation: Department of Public Health, Ghent University, Gent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Clays
mesh_terms: D000367:Age Factors; D000368:Aged; D002309:Cardiology / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D012737:Sex Factors; D012955:Societies, Medical
keywords: Coronary heart disease; EUROASPIRE; Gender