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June 25, 2013Kardiologia Polska9 citationsOpen Access

Age, sex, and secondary prevention of ischaemic heart disease in everyday practice

PJPiotr JankowskiDCDanuta CzarneckaRWRenata Wolfshaut–Wolak

Key Result

Female patients were prescribed calcium antagonists (OR 2.13) and diuretics (OR 1.52) significantly more often than male patients 6 to 18 months after hospitalization for ischaemic heart disease.

Study Design

Type

Observational (n=640)

Multicenter

Yes

Structured PICO

Are there sex- and age-related differences in the secondary prevention management of patients hospitalized for ischaemic heart disease?

P
Population
640 patients aged 80 years or younger hospitalized for acute coronary syndrome or myocardial revascularization in Poland, followed up at 6 to 18 months to assess secondary prevention practices.
O
Outcome
Sex- and age-related bias in secondary prevention (prescription rates of cardiovascular drugs and control of major risk factors) at discharge and 6-18 months after hospitalisation

This study demonstrates that in everyday practice in Poland, there are no major sex-related biases in secondary prevention of ischemic heart disease, though older age is associated with poorer blood pressure control.

Main Result

Odds Ratio: 2.13 (95% CI 1.34–3.39)

Absolute Event Rate: 32.5% vs 17.7%

p-value: p=<0.001

Limitations

  • Inability to assess the risk of cardiovascular complications
  • Potential unrecognised differences in the subgroups handled by particular hospitals or across diagnostic groups
  • Study population was limited to patients hospitalized for acute CAD events or revascularisation, and thus not representative of all CAD patients
  • Unable to assess the risk of cardiovascular complications
  • Groups analysed were not representative of all CAD patients as they were limited to patients hospitalised for acute CAD events or revascularisation procedures

Abstract

BACKGROUND: Many researchers have studied age- and sex-related differences in the management of patients with coronary artery disease. However, the results are inconsistent. AIM: To assess sex- and age-related bias in the secondary prevention in patients hospitalised due to ischaemic heart disease. METHODS: Five hospitals with departments of cardiology serving a city and surrounding districts in southern Poland participated in the study. Consecutive patients hospitalised from 1 April 2005 to 31 July 2006 due to acute coronary syndrome or for a myocardial revascularisation procedure and aged ≤ 80 years were recruited and interviewed 6-18 months after hospitalisation. RESULTS: The hospital records of 640 patients were reviewed and 513 (80.2%) patients participated in the follow-up interview. Women were older and less educated than their male counterparts. Sex was not independently associated with the control of major risk factors in the post-discharge period, whereas age was related to a higher probability of having high blood pressure and a lower chance of smoking. Multivariate analysis showed that females were prescribed calcium antagonists (odds ratio OR 2.13; 95% confidence intervals CI 1.34-3.39) and diuretics (OR 1.52; 95% CI 1.00-2.31) more often than males. Age was independently related to the prescription rate of diuretics (≥ 70 years vs. < 60 years; OR 1.61; 95% CI 1.19-2.20). The prescription rate of antiplatelets, beta-blockers, angiotensin converting enzyme-inhibitors/sartans, lipid-lowering drugs, and anticoagulants was not related to age or sex. CONCLUSIONS: We found no major sex-related difference in the frequency of achieving recommended goals in secondary prevention, whereas age was related to a lower prevalence of smoking and a higher probability of having high blood pressure in subjects after hospitalisation for coronary artery disease.

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Cite This Study

Jankowski et al. (2013) conducted an observational in Ischaemic heart disease (n=640). Female sex vs. Male sex was evaluated on Prescription of calcium antagonists at 6-18 months (OR 2.13, 95% CI 1.34-3.39, p=<0.001). Female patients were prescribed calcium antagonists (OR 2.13) and diuretics (OR 1.52) significantly more often than male patients 6 to 18 months after hospitalization for ischaemic heart disease.

synapsesocial.com/papers/6a71c4e8439bab0cabc3aaf0https://doi.org/10.5603/kp.a2013.0148
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Also Consider

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  1. 1Evidence for an age and gender bias in the secondary prevention of ischaemic heart disease in primary care2003 · 101 citations
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