Gender inequalities in cardiovascular risk factor assessment and management in primary healthcare

Karice K. Hyun*, Julie Redfern, Anushka Patel, David Peiris, David Brieger, David Sullivan, Mark Harris, Tim Usherwood, Stephen MacMahon, Marilyn Lyford, Mark Woodward

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

98 Citations (Scopus)

Abstract

Objectives: 

To quantify contemporary differences in cardiovascular disease (CVD) risk factor assessment and management between women and men in Australian primary healthcare services. 

Methods: 

Records of routinely attending patients were sampled from 60 Australian primary healthcare services in 2012 for the Treatment of Cardiovascular Risk using Electronic Decision Support study. Multivariable logistic regression models were used to compare the rate of CVD risk factor assessment and recommended medication prescriptions, by gender. 

Results: 

Of 53 085 patients, 58% were female. Adjusting for demographic and clinical characteristics, women were less likely to have sufficient risk factors measured for CVD risk assessment (OR (95% CI): 0.88 (0.81 to 0.96)). Among 13 294 patients (47% women) in the CVD/high CVD risk subgroup, the adjusted odds of prescription of guideline-recommended medications were greater for women than men: 1.12 (1.01 to 1.23). However, there was heterogeneity by age ( p <0.001), women in the CVD/high CVD risk subgroup aged 35-54 years were less likely to be prescribed the medications (0.63 (0.52 to 0.77)), and women in the CVD/high CVD risk subgroup aged ≥65 years were more likely to be prescribed the medications (1.34 (1.17 to 1.54)) than their male counterparts. 

Conclusions: 

Women attending primary healthcare services in Australia were less likely than men to have risk factors measured and recorded such that absolute CVD risk can be assessed. For those with, or at high risk of, CVD, the prescription of appropriate preventive medications was more frequent in older women, but less frequent in younger women, compared with their male counterparts. Trial registration number 12611000478910, Pre-results.

Original languageEnglish
Pages (from-to)500-506
Number of pages7
JournalHeart
Volume103
Issue number7
DOIs
Publication statusPublished - 1 Apr 2017
Externally publishedYes

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