Gender-sensitive approach to hypolipidemic therapy: experience from a Ukrainian cohort of patients with coronary heart disease and comorbidities

Background. Coronary heart disease (CHD) remains the leading cause of mortality in Ukraine. One of the key factors influencing the effectiveness of secondary prevention in patients at high and very high cardiovascular risk is adherence to hypolipidemic pharmacotherapy, particularly with statins. Multicomponent pharmacotherapy of such patients attracts special attention and requires analysis of the impact of gender characteristics and the intensity of the prescribed hypolipi-demic therapy on adherence to treatment. The purpose was to identify the factors influencing adherence to varying intensities of hypolipidemic therapy in patients with coronary heart di­sease and comorbidities, considering gender differences. Materials and methods. This observational study analyzed medical data from patients with CHD and comorbid conditions who suffered from cardiovascular events. Adherence to hypolipi­demic therapy was assessed using the five-point MARS-5. The intensity of statin therapy and dose adjustments one year after the index event were evaluated. Statistical methods included descriptive analysis, Pearson’s chi-square test adjusted for likelihood ratio, Cramer’s V, Spearman’s rho, Pearson’s r, gamma coefficient, and Somers’ d to assess the direction and strength of associations between ordinal variables. Results. A statistically significant and moderately strong correlation was found between gender and adherence to hypolipidemic therapy ((2) = 26.518, p < 0.001; Cramer’s V = 0.428). Conclusions. Men showed significantly higher adherence to statin therapy (84.3 %) compared to women (66.6 %). It was confirmed that the highest adherence to hypolipidemic agents was observed when switching from high- to moderate-intensity therapy in patients at high cardiovascular risk (gamma = –0.579; p = 0.005).