Source/Disclosures
Disclosures: Peters and Zhao report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
May 20, 2020
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Some CV medications prescribed less often to women than men

Source/Disclosures
Disclosures: Peters and Zhao report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Sanne A.E. Peters

Women with established CVD had lower rates of prescriptions for statins, aspirin and ACE inhibitors compared with men, according to a systematic review and meta-analysis published in the Journal of the American Heart Association.

Men with established CVD had a lower prescription rate for diuretics, according to the study.

“Our study shows that there are a lot of people who do not receive guideline-recommended medications, and this gap is even larger for women than for men for some medications,” Sanne A.E. Peters, PhD, research fellow in epidemiology at The George Institute for Global Health at the University of Oxford in the United Kingdom and associate professor at the University Medical Center Utrecht in the Netherlands, told Healio. “Additional efforts need to be taken to ensure that everyone who should receive heart attack medications actually receives these medications. We also need to reduce the persistent treatment gaps between women and men. Patients should talk with their physicians about the benefits of using heart disease medications and weigh them against the potential risks.”

Sex-specific prevalence of medications

Min Zhao, PhD, research associate at the Julius Centre for Health Sciences and Primary Care at University Medical Center Utrecht, and colleagues analyzed data from 2,264,600 participants (28% women; mean age, 51-76 years) from 43 studies that were conducted between 2000 and 2019. The observational studies included in this analysis reported on the sex-specific prevalence of CV medication prescriptions including statins, aspirin and any antihypertensive medication for high-risk patients or for those with established CVD being treated by primary care. Established CVD included stroke, CHD, atrial fibrillation and HF.

The primary outcome for this study was the women to men prescription prevalence ratio. Secondary outcomes included the sex-specific prescription rates for each CV medication.

The pooled prevalence of CV medication prescription in women was 60% for statins, 41% for aspirin and 68% for overall antihypertensive medications. The rates for men were 63% for statins, 56% for aspirin and 69% for overall antihypertensive medications. The pooled women to men prevalence ratios were 0.9 for statins (95% CI, 0.85-0.95), 0.81 for aspirin (95% CI, 0.72-0.92) and 1.01 for any antihypertensive medications (95% CI, 0.95-1.08).

Compared with men, women were less likely to receive prescriptions for ACE inhibitors (women to men prevalence ratio = 0.85; 95% CI, 0.81-0.89). In contrast, women were more likely to be prescribed diuretics vs. men (women to men prevalence ratio = 1.27; 95% CI, 1.17-1.37).

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Researchers did not observe any significant impact on findings related to mean age difference between sexes, mean age and study year.

Potential explanations

“Our study was not designed to identify the reasons behind these sex differences,” Peters said in an interview. “However, sex differences may be related to differences in the presentation and progression of heart disease and comorbidities. Women are generally older than men when they experience a heart attack and may therefore experience more adverse drug effects. Also, because women generally experience their first heart attack later in life than men, this might have led misperception that CVD is less common in women and does not have to be prevented as intensively as in men.” – by Darlene Dobkowski

For more information:

Sanne A.E. Peters, PhD, can be reached at sanne.peters@georgeinstitute.ox.ac.uk.

Disclosures: Peters and Zhao report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.