Among 75-year-olds with cardiovascular disease, men were significantly more likely than women to achieve the secondary prevention treatment target for LDL-C (38% vs. 25%, OR 1.82).
Cross-Sectional (n=621)
No
Are there sex differences in the achievement of cardiovascular disease prevention targets and medication use among 75-year-old adults?
In 75-year-old adults, women are significantly less likely than men to achieve secondary prevention targets for LDL-C and blood pressure or to receive lipid-lowering therapy, highlighting a critical sex disparity in cardiovascular care.
Effect estimate: OR 1.82 (95% CI 1.07-3.11)
Absolute Event Rate: 38% vs 25%
Background The burden of cardiovascular diseases (CVDs) must be reduced through prevention. This study aimed to assess sex differences in the implementation of secondary and primary prevention of CVDs based on risk factor levels among 75-year-old community-dwelling Finns. Methods The study included 75-year-old participants of the Turku Senior Health Clinic Study with CVD (n = 260) or with high or very high 5-year risk for CVD according to SCORE2-OP (n = 361). The achievement of low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG) levels, as well as the use of evidence-based medications recommended by disease-specific treatment guidelines, were assessed. Logistic regression analysis was used to explore sex differences in achieving national treatment targets. Results In the secondary prevention of CVD, more men than women achieved the treatment target levels for LDL-C (38% vs. 25%, respectively) (OR 1.82, 95% CI 1.07–3.11), SBP (18% vs. 9%) (OR 2.24, 95% CI 1.05–4.79), and DBP (41% vs. 30%) (OR 1.69, 95% CI 1.01–2.82). Additionally, men were more likely than women to use lipid-lowering (82% vs. 70%) (OR 1.95, 95% CI 1.08–3.49) and diabetes (27% vs. 14%) (OR 2.16, 95% CI 1.15–4.05) medications. Among those using antihypertensives, men were more likely than women to meet the treatment target levels for SBP (19% vs. 9%) (OR 2.36, 95% CI 1.03–5.43) and DBP (43% vs. 30%) (OR 1.78, 95% CI 1.01–3.13). In the primary prevention of CVD, the only significant sex differences were observed in the use of antihypertensive medications: men were less likely than women to use agents acting on the renin-angiotensin system (45% vs. 62%) (OR 0.49, 95% CI 0.32–0.74) or any antihypertensive medications (57% vs. 74%) (OR 0.46, 95% CI 0.29–0.72). Conclusions In primary care, there is a need for improvements in both secondary and primary prevention of CVDs in older adults, particularly in addressing elevated SBP and LDL-C levels. Moreover, the insufficient treatment of women in secondary prevention is a significant concern. Trial registration ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.
Salminen et al. (Wed,) conducted a cross-sectional in Cardiovascular disease and high CVD risk (n=621). Male sex vs. Female sex was evaluated on Achievement of LDL-C treatment target (<1.4 mmol/l) in secondary prevention (OR 1.82, 95% CI 1.07-3.11). Among 75-year-olds with cardiovascular disease, men were significantly more likely than women to achieve the secondary prevention treatment target for LDL-C (38% vs. 25%, OR 1.82).